Suicide watch: What we know about the Epstein case and how it works in Canada

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What is a suicide watch?
WATCH: What is a suicide watch? – Aug 13, 2019

Jeffrey Epstein was not on suicide watch when he apparently took his own life in a New York City jail over the weekend.

The Metropolitan Correctional Center (MCC), where Epstein was found dead in his cell, had previously been hailed for its ability to hold notorious prisoners under tight security.

What happened?

There are still many unanswered questions surrounding the alleged sex trafficker’s death.

Epstein was placed on suicide watch after he was reportedly found in his cell with bruises on his neck on July 23. The 66-year-old was awaiting charges after he was accused of recruiting and sexually abusing dozens of young girls for years.

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He was taken off suicide watch at the end of July and moved back to a special housing unit in the jail.

Epstein was found dead on Aug. 10. The manner in which he is believed to have killed himself has not been announced publicly.

The MCC is now being examined by both the FBI and the Office of the Inspector General.

What sort of watch was Epstein under?

In U.S. federal jails, inmates placed on suicide watch face “direct, continuous observation” for every day they are under the order, according to the U.S. Bureau of Prisons policy.

However, procedures for prevention vary across federal, state and local systems. In some cases, depending on individualized assessments, inmates are monitored in 15-minute intervals.

A suicide watch typically lasts 72 hours.

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While under suicide watch, it’s believed Epstein was moved to a psych unit at MCC.

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“There are very strict procedures about how you do suicide watches in New York prisons,” said Ross McLean, a crime specialist, security expert and former Toronto police officer.

“At the highest level, someone is sitting in front of you, of your cell, looking at you 24-7 and keeping a log.”

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Jeffrey Epstein dies by apparent suicide in prison

At MCC, as reported by Forbes, there are five holding cells in the psych unit. Typically, someone is assigned to watch the inmate through a glass window in a heavy steel door and take regular notes about their activities.

“Most of these cells are designed so they’re suicide-proof, if you will, so there’s nothing you can hang yourself off of… Everything is low to the floor,” Ross told Global News’ The Roy Green Show.

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Inmates in these cells cannot have utensils and can only eat finger foods.

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After a 72-hour period, officials decide whether to move the inmate into a medical facility for further evaluation or treatment or to place them under less intensive monitoring.

At some point, to the bafflement of many prison experts, Epstein was taken off suicide watch.

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He was transferred to another holding cell — the special handling unit — which Ross described as “the hole.” The cell is a highly restrictive level of prison generally reserved for dangerous offenders.

“Procedures say if you’re on suicide watch, you’re specifically not supposed to be in that unit,” he said.

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Guards were reportedly directed to check on Epstein every 30 minutes or so, but those checks were not done for several hours before he was found dead, the Associated Press reported.

Additionally, one of the guards assigned to monitor that night was a fill-in who had been pressed into service because of staffing shortages.

The official reasons for Epstein being taken off suicide watch remain unknown. There are reports that Epstein was given another psychiatric evaluation where he was cleared and returned to his previous holding cell.

According to the federal Bureau of Prisons guidelines, an inmate’s suicide watch “may not be terminated, under any circumstance, without the program co-ordinator designee performing a face-to-face evaluation.”

“Normally, in prisons, things are recorded pretty well about who’s where, when and why when they’re in a unit,” Ross said. “They’ll be interviewing people to find out what happened here.”

How does it work in Canada?

In Canada’s federal prisons, there are three levels of suicide watch — high, modified and mental health monitoring.

Under both high and modified watch, inmates are expected to receive a mental health assessment by a health-care professional within 24 hours of being placed under the measure.

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“But that depends on the institution because sometimes they’re not available,” said Adelina Iftene, an expert in prison law and a professor at Dalhousie’s Schulich School of Law.

“It’s a very intrusive form of observation. It’s more disciplinary, really, than it is medically, especially if you’re not done under medical supervision.”

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Suicide watches in Canada, like in the U.S., are subject to a period of 72 hours but can be extended.

During that time, the inmate’s activities should be documented “as required, but at least every 15 minutes,” according to the Correctional Service of Canada.

“In a high watch, you really don’t have anything. You have a suicide gown and, sometimes, you have a mattress, but not always,” Iftene said.

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“They have to put you in a cell where they can monitor you physically 24 hours a day.”

Corrections Canada guidelines say high watch is for an inmate at an “elevated or imminent risk” of suicide. Often times, it is applied to a person who has already engaged in self-harm or has been assessed by a medical professional.

A modified watch is direct observation conducted through CCTV by an officer.

“Monitor screens will be situated in posts in such a way as to ensure the inmate’s privacy,” Corrections Canada guidelines say.

In the U.S., most federal jails focus cameras on common areas rather than cells.

“Modified watch, you’re a bit of a lower risk,” said Iftene. “You can have cutlery to eat with, you have your bed, stuff like that.”

Both are considered a “last resort” after all other de-escalation strategies have been tried or considered.

Iftene believes mental health monitoring should be the norm but acknowledged that it isn’t always possible, noting that staffing often hinders the procedure.

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When a health-care professional is unavailable at the prison, other staff members, like correctional officers, can be authorized to perform mental health monitoring.

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Iftene claims this can lead to lapses in observation.

She said understaffing within federal and provincial systems, particularly with mental health professionals, is a “chronic” problem.

“Correctional officers themselves are applying a risk assessment tool they have that can be applied by non-health professionals,” she said.

“Unfortunately, there is a fairly grim history with how that has worked in the past. There have been a lot of situations that were missing.”

Iftene pointed to the case of Ashley Smith, who died in 2007 by self-strangulation at the Kitchener, Ont., prison.

The 19-year-old, who struggled with mental health issues, had spent more than 1,000 days in segregation and had repeatedly been transferred between institutions. Guards reportedly hesitated in rushing to remove a ligature the young inmate had tied around her neck because of orders from senior management not to intervene as long as she was still breathing.

The case thrust Canada’s correctional system into the spotlight, with solitary confinement policies at the centre of the controversy.

A coroner’s inquest jury later ruled her death a homicide. Solitary confinement regulations have since crawled along and stoked criticism.

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“It may sound like high suicide watch is better at preventing self harm and death but, again, it’s not medical care and does not replace the medical care these people may need,” said Iftene.

“Ashley Smith was on a high suicide watch, and their [the officers’] instructions were not to intervene because her behaviour was deemed attention-seeking behaviour; so she basically died while officers were watching.”

— With files from the Associated Press

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