How was he able to kill him­self af­ter ear­lier re­ported in­ci­dent?

Miami Herald (Sunday) - - FRONT PAGE - BY BEN CONARCK [email protected]­ami­her­ald.com

Ac­cused sex traf­ficker Jef­frey Ep­stein’s death by ap­par­ent sui­cide in a Man­hat­tan jail cell on Sat­ur­day raised sig­nif­i­cant ques­tions about whether de­ten­tion of­fi­cials made ap­pro­pri­ate de­ci­sions about his hous­ing sta­tus and po­ten­tial to take his own life.

Ep­stein’s death is a pro­found em­bar­rass­ment for the fed­eral Bureau of Pris­ons, which runs the fa­cil­ity, and is sure to anger the De­part­ment of Jus­tice, which had just as­sem­bled a case against him.

In a state­ment, fed­eral of­fi­cials con­firmed that Ep­stein died at 6:30 a.m. Sat­ur­day in the Spe­cial Hous­ing Unit at the Metropoli­tan Cor­rec­tional Center in Man­hat­tan, a lockup that has held in

fa­mous de­tainees, from mob­ster John Gotti to Ponzi schemer Bernie Mad­off to Joaquín “El Chapo” Guzmán, the Mex­i­can drug king­pin. Of­fi­cials said only that Ep­stein was found un­re­spon­sive in his cell and added that the FBI would be in­ves­ti­gat­ing.

Though con­firmed de­tails were scarce, vir­tu­ally every­one fa­mil­iar with Ep­stein’s case had the same ques­tion: How could a high-pro­file in­mate im­pli­cated in a wide-rang­ing child sex traf­fick­ing ring kill him­self, mere weeks af­ter what sounded very much like an ear­lier at­tempt?

NO SUI­CIDE WATCH

And yet var­i­ous news out­lets re­ported that he was not on sui­cide watch at the time of his death.

Sea­soned prison lit­i­ga­tors and sui­cide pre­ven­tion ex­perts were not shocked that such an event could oc­cur, but they agreed that the ap­par­ent sui­cide raised se­ri­ous ques­tions about the men­tal health treat­ment and eval­u­a­tion Ep­stein re­ceived at the fa­cil­ity.

“Why, if he had shown sui­ci­dal­ity, was he placed in the [Spe­cial Hous­ing Unit?]” asked Eric Bal­a­ban, a se­nior staff coun­sel with the Na­tional Prison Pro­ject of the Amer­i­can Civil Lib­er­ties Union, who has lit­i­gated against pris­ons and jails for more than 25 years.

Bal­a­ban de­scribed the spe­cial hous­ing unit as a “puni­tive, iso­lated unit” that was “not ap­pro­pri­ate for some­one who’s shown re­cent sui­cide at­tempts.”

“The Bureau of Pris­ons has guide­lines that you don’t place pris­on­ers there who have se­ri­ous men­tal ill­ness or are po­ten­tially sui­ci­dal,” he said. “You’re cre­at­ing a risk.”

It was re­ported that Ep­stein was placed on sui­cide watch af­ter the pre­vi­ous in­ci­dent on July 22. Ac­cord­ing to re­ports at the time, he was found semi-con­scious with bruises around his neck.

In or­der to be cleared to be taken off sui­cide watch at a fed­eral fa­cil­ity, in­mates must go through rig­or­ous, struc­tured in­ter­views.

“It’s con­ceiv­able that in three weeks’ time he had sta­bi­lized or ap­par­ently con­vinced men­tal health staff that he was no longer sui­ci­dal and they felt con­fi­dent in a clin­i­cal sense to re­move him,” said Lind­say M. Hayes, the pro­ject di­rec­tor of the Na­tional Center on In­sti­tu­tions and Al­ter­na­tives, an ex­pert on sui­cide pre­ven­tion in pris­ons and jails.

But Hayes and Bal­a­ban agreed that if men­tal health providers made such a de­ci­sion, it would come un­der heavy scru­tiny. Typ­i­cally, in­mates at fed­eral fa­cil­i­ties who are placed on sui­cide watch un­dergo daily vis­its with a psy­chi­a­trist and some­times a physi­cian’s as­sis­tant, they said. The providers would have then had to per­form an as­sess­ment to de­ter­mine whether Ep­stein was still at risk be­fore tak­ing him off sui­cide watch.

There are vary­ing de­grees of sui­cide watch in fed­eral fa­cil­i­ties, with the high­est level of pre­cau­tion be­ing con­tin­u­ous one-onone ob­ser­va­tion by an of­fi­cer as­signed to that par­tic­u­lar pris­oner. A lower level of watch would in­volve of­fi­cers tak­ing rounds at 15- or 30-minute in­ter­vals to check on the pris­oner, ac­cord­ing to Bal­a­ban and Hayes.

An in­mate would be pro­hib­ited from pos­sess­ing cloth­ing, blan­kets or any­thing that could be used for self-harm. Bal­a­ban said there are sui­cide blan­kets and sui­cide vests that are highly re­sis­tant.

“A pris­oner like Mr. Ep­stein, who had ap­par­ently al­ready made an at­tempt to hang him­self ... it’s Sui­cide Pre­ven­tion 101 for any pris­oner that at­tempts sui­cide that you don’t give them the means,” Bal­a­ban said.

Hayes said sui­cide watch is a puni­tive en­vi­ron­ment. In­mates are locked down and rarely let out of their cells for any rea­son. They are of­ten stripped of their cloth­ing and placed in a sui­cide smock. They are given fin­ger foods be­cause they are not al­lowed to have uten­sils.

“Be­cause it’s so puni­tive ap­pear­ing, many in­mates deny that they’re sui­ci­dal even though they might be be­cause they want their clothes back. They want to get out of their cell,” he said.

Deb­o­rah Golden, a staff at­tor­ney at the Hu­man Rights De­fense Center who is also a sea­soned prison lit­i­ga­tor, said the Bureau of Pris­ons has a long his­tory of in­ad­e­quate men­tal health­care, most no­tably short­ages of psy­chi­a­trists on staff.

‘A BAD JOB’

“They do a bad job at sui­cide pre­ven­tion,” Golden said. “They don’t have a humane sys­tem for mon­i­tor­ing some­one. It’s con­sid­ered more like a dis­ci­plinary infraction: at­tempt­ing self-harm.”

Hayes said sui­cide risk as­sess­ments can be very chal­leng­ing for men­tal health pro­fes­sion­als in cor­rec­tional set­tings.

“There are so many things that a clin­i­cian has to take into ac­count: a per­son’s back­ground, the charges they’re fac­ing,” he said. “In this case, they have a very high-pro­file client that they’re as­sess­ing. It’s not the typ­i­cal in­mate.”

Laura de las Casas, a pris­oner rights ad­vo­cate based in Wash­ing­ton, D.C., said she in­spected about 20 Bureau of Pris­ons fa­cil­i­ties when she served on the DC Cor­rec­tions In­for­ma­tion Coun­cil, an in­de­pen­dent watch­dog group, for three years.

De las Casas, who fo­cused on sui­cide pre­ven­tion and men­tal health dur­ing those in­spec­tions, said fed­eral fa­cil­i­ties are of­ten so un­der­staffed that they are re­act­ing to sui­cide at­tempts rather than fo­cus­ing on pre­vent­ing them.

“That’s the way they op­er­ate,” she said. “That’s why, even though he may have been placed on sui­cide watch in July, once they be­lieve he won’t com­mit sui­cide to­mor­row, they place him back in a cell.”

The time at which Ep­stein was dis­cov­ered in his cell, 6:30 a.m., in­di­cated to de las Casas that he was found dur­ing morn­ing count, and the sui­cide at­tempt could have taken place hours ear­lier.

“It’s that in­abil­ity to watch some­one or mon­i­tor some­one that makes it im­pos­si­ble for the BOP to ac­tu­ally pre­vent sui­cides,” she said.

De las Casas added that it’s gen­er­ally eas­ier for an in­mate to com­mit sui­cide in a spe­cial hous­ing unit be­cause there’s less move­ment of of­fi­cers and other in­mates.

POS­SI­BLE LIFE TERM

Ep­stein — a mul­ti­mil­li­ion­aire with homes all over the world, a pri­vate jet and a taste for lux­ury — was fac­ing spend­ing the rest of his life in prison if con­victed of the sex traf­fick­ing charges in his in­dict­ment. Ad­di­tion­ally, in­mates ac­cused of sex­u­ally abus­ing chil­dren — as was Ep­stein — can face harsh treat­ment at the hands of fel­low in­mates and some­times have to be seg­re­gated from the rest of the prison pop­u­la­tion.

Chris­tine Tar­taro, a pro­fes­sor of crim­i­nal jus­tice at Stockton Univer­sity in New Jer­sey, said that while Ep­stein’s death raises con­cerns about how he was han­dled be­hind bars, in­mate sui­cides are com­mon in pre­trial fa­cil­i­ties.

“They are the lead­ing cause of deaths in jails,” said Tar­taro, the au­thor of “Sui­cide and Self-Farm in Pris­ons and Jails.”

Even the fact that Ep­stein had pre­vi­ously been on sui­cide watch, then moved off of it, is not un­usual in jail set­tings, said Tar­taro. With­out ac­cess to Ep­stein’s psy­cho­log­i­cal as­sess­ments, it’s im­pos­si­ble to know if his case was han­dled prop­erly, she said.

“The point of sui­cide watch is to get them through the ini­tial sui­cide cri­sis, and then to work on help­ing the in­mate nav­i­gate the cor­rec­tional en­vi­ron­ment with­out at­tempt­ing sui­cide,” Tar­taro said.

“There are sit­u­a­tions in which the in­mate will feel bet­ter and then regress and be­come sui­ci­dal again.”

Ac­cord­ing to the U.S. Bureau of Jus­tice Sta­tis­tics, the na­tion’s jails had a sui­cide rate of 46 per 100,000 in 2013, the last re­ported year. That’s higher than the rate in gen­eral so­ci­ety, and in pris­ons, where in­mates have been al­ready con­victed.

Sen. Ben Sasse, a Ne­braska Repub­li­can who has been highly crit­i­cal of the Jus­tice De­part­ment’s han­dling of Ep­stein, sent a let­ter to Barr on Sat­ur­day say­ing “given Ep­stein’s pre­vi­ous at­tempted sui­cide, he should have been in a padded room un­der un­bro­ken, 24/7 con­stant sur­veil­lance.”

The se­na­tor added: “Heads must roll.”

BEBETO MATTHEWS AP

New York City med­i­cal ex­am­iner per­son­nel walk to the Man­hat­tan Cor­rec­tional Center, where Ep­stein was held un­til his sui­cide Sat­ur­day.

EMILY MICHOT emi­[email protected]­ami­her­ald.com

The Metropoli­tan Cor­rec­tional Center in Lower Man­hat­tan, where Jef­frey Ep­stein was be­ing held un­til he killed him­self Sat­ur­day.

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