Suicide Prevention Program (Program Statement 5332.01)

By Elizabeth Franklin-Best, Esq., and Christopher Zoukis, JD, MBA

Field	Value
Program Statement	5332.01
Subject	Suicide Prevention Program
Effective / current edition	03-19-2026
Change notices	None. The statement is the original 5332.01 issuance; BOP’s published policy list carries it with no change notice.
Supersedes	PS 5324.08, Suicide Prevention Program (4/5/2007), rescinded — PS 5332.01 at p. 1. Note the series change: the policy moved from the 5324 series to a new 5332 number.
Governing statute	The Program Statement cites none in its own authority line. The Bureau’s general duties are 18 U.S.C. § 4042(a)(2)–(3) — to “provide for the safekeeping, care, and subsistence of all persons charged with or convicted of offenses against the United States” and to “provide for the protection, instruction, and discipline” of the same people.
28 C.F.R. anchor	28 C.F.R. part 552, subpart E — Suicide Prevention Program, §§ 552.40, 552.41, 552.42. Part 552 is titled “Custody.” Verified section by section; the brief left this field blank. Not part 549 — that is Medical Services.
Related BP forms	BP-A1182, Self-Directed Violence High Lethality Review (new with this edition) · BP-A1183, Suicide Watch Property Authorization (new with this edition) · BP-A0519, Psychology Services Inmate Questionnaire (PSIQ)
Official PDF	bop.gov/policy/progstat/5332_001-1.pdf

Checked against the BOP policy set · 2026-09-06. Verification methodology: see our How We Verify page.

Program Statement 5332.01, effective March 19, 2026, is the Bureau of Prisons’ current instruction to staff on identifying people at risk of suicide, placing them on suicide watch, watching them, treating them, and deciding when the watch ends. It is one of the few areas of prison mental health that has a real regulation behind it — 28 C.F.R. §§ 552.40–552.42 — and the companion plain-language page is Mental Health Programs for Inmates.

This page exists because families ask two questions and get answers from nobody: what is actually happening to my son or daughter right now, and what is the institution supposed to be doing. Both have written answers. They are set out below in the Bureau’s own words, with the page number in the Bureau’s own PDF, so you can check them. If you or someone you love is in crisis right now, the practical paragraph is at the end of the “Where people get stuck” section below — and 988 reaches the Suicide and Crisis Lifeline from anywhere in the United States, by call or by text.

The rule itself: suicide prevention

Everything in this section is transcribed from the Bureau’s own text at bop.gov/policy/progstat/5332_001-1.pdf. This Program Statement reprints its regulation inside the policy text, so some passages below are law and some are staff instruction; the two are separated in What binds and what does not, further down.

The regulation

Three short sections carry the whole regulatory scheme. 28 C.F.R. § 552.40, reprinted at PS 5332.01 p. 2 and verified against the Code of Federal Regulations:

The Bureau of Prisons (Bureau) operates a suicide prevention program to assist staff in identifying and managing potentially suicidal inmates. When staff identify an inmate as being at risk for suicide, staff will place the inmate on suicide watch. Based upon clinical findings, staff will either terminate the suicide watch when the inmate is no longer at imminent risk for suicide or arrange for the inmate’s transfer to a medical referral center or contract health care facility.

28 C.F.R. § 552.41, Program procedures, reprinted in pieces across pp. 3, 8, 10 and 12:

(a) Program Coordinator. Each institution must have a Program Coordinator for the institution’s suicide prevention program. (b) Training. The Program Coordinator is responsible for ensuring that appropriate training is available to staff and to inmates selected as inmate observers. (c) Identification of at risk inmates. (1) Medical staff are to screen a newly admitted inmate for signs that the inmate is at risk for suicide. Ordinarily, this screening is to take place within twenty-four hours of the inmate’s admission to the institution. (2) Staff (whether medical or non-medical) may make an identification at any time based upon the inmate’s observed behavior. (d) Referral. Staff who identify an inmate to be at risk for suicide will have the inmate placed on suicide watch. (e) Assessment. A psychologist will clinically assess each inmate placed on suicide watch. (f) Intervention. Upon completion of the clinical assessment, the Program Coordinator or designee will determine the appropriate intervention that best meets the needs of the inmate.

28 C.F.R. § 552.42, Suicide watch conditions, reprinted at pp. 15, 17, 18 and 23:

(a) Housing. Each institution must have one or more rooms designated specifically for housing an inmate on suicide watch. The designated room must allow staff to maintain adequate control of the inmate without compromising the ability to observe and protect the inmate. (b) Observation. (1) Staff or trained inmate observers operating in scheduled shifts are responsible for keeping the inmate under constant observation. (2) Only the Warden may authorize the use of inmate observers. (3) Inmate observers are considered to be on an institution work assignment when they are on their scheduled shift. (c) Psychological Observation log. Observers are to document significant observed behavior in a log book. (d) Termination. Based upon clinical findings, the Program Coordinator or designee will: (1) Remove the inmate from suicide watch when the inmate is no longer at imminent risk for suicide, or (2) Arrange for the inmate’s transfer to a medical referral center or health care facility.

Everything else on this page is the Bureau’s implementing instruction — far more detailed than the regulation, and the part that actually governs day-to-day practice.

What a suicide watch is, and what it is not

A suicide watch is a housing and observation status, not a punishment and not a disciplinary sanction. Two features define it under the 2026 policy: the person is moved into a room designated for the purpose, and a human being watches them continuously, in person.

The location rule is specific. PS 5332.01 at p. 15: “Inmates on suicide watch will be placed in one of the institution’s designated suicide watch rooms, a non-restrictive housing unit room, ordinarily located in the Health Services area.” And, on the same page, the exclusion families most need to know about: “administrative detention and disciplinary segregation cells will not be designated or used as suicide watch cells.” Putting a watch room anywhere outside Health Services takes a waiver from the Warden through the Regional Director to the Assistant Director over the Psychology Services Branch, renewed annually, with a list of current waivers held by each Regional Psychology Services Administrator (p. 15). Under emergency conditions a person may be placed temporarily in another cell “as long as all other conditions of suicide watch are met,” and “[a]s soon as an officially designated suicide watch room becomes available, the inmate must be relocated to that room” (p. 15).

The 2026 edition also widened who may be placed on watch. PS 5332.01 at p. 14: “Suicide watch may be used for individuals who have an increased risk of suicide or increased need for support and observation due to acute mental illness (i.e., individuals who present with psychosis or significant behavioral dysregulation related to mental health concerns and cannot be celled with another person but does not present with increased risk factors for death by suicide).” And at p. 15: “If inmates do not present with significant suicide risk, but their functioning in general population or in restrictive housing is severely compromised, they may also be placed on suicide watch. Regardless of the reason for suicide watch, cell conditions will often look similar.” So a person can be on a watch without having been assessed as suicidal — a distinction that matters enormously to a family being told over the phone that their relative is “on suicide watch.”

There is also a separate, lesser status that gets confused with it. Before a psychologist has assessed anyone, the policy directs constant visual observation as an immediate holding measure: “Safety precautions (i.e., constant visual observation or suicide watch) must be implemented immediately and until Psychology Services conducts a formal SRA” (p. 11). Constant visual observation pending assessment is not the same thing as a suicide watch that a psychologist has ordered — but from the outside they look identical.

The observation intervals — the part that matters most

This is the section people come for, and the 2026 edition changed it. Each row is transcribed from the passage cited.

What	The Program Statement’s own words	Pin-cite
Method of observation	“Inmates on suicide watch require constant visual, in-person observation. At no time should video monitoring of any type be used as the primary method of monitoring an inmate on suicide watch.”	PS 5332.01 at p. 17
Cameras excluded	“Under no circumstances can electronic monitoring (e.g., cameras) be used as the primary observation method of the inmate placed on suicide watch. All monitoring of the inmate on suicide watch must be done through constant direct visual observation.”	PS 5332.01 at p. 15
Log entries	“Entries will ordinarily be made in at least 15-minute intervals.”	PS 5332.01 at p. 17
Post orders	“Suicide watch post orders must reflect the requirement that suicide watch log entries are documented at least every 15 minutes.”	PS 5332.01 at p. 18
One observer, one person watched	“At non-MRC sites, observers may only monitor one inmate on suicide watch. A separate observer must be assigned to each inmate on suicide watch. Ordinarily, staff observers and Suicide Watch Companions will not work side-by-side in this capacity.”	PS 5332.01 at p. 17
At a medical referral center	“At MRCs, observers may watch no more than two inmates on suicide watch if they can be reasonably and easily maintained in the field of vision without the use of video monitoring.”	PS 5332.01 at p. 17
The observer’s ability to get help	“The observer must have a means to summon help immediately (e.g., phone, two-way radio) if the inmate on suicide watch displays any self-injurious or dangerous behaviors.”	PS 5332.01 at p. 17
Staff checks when an inmate is the observer	“Supervision of Suicide Watch Companions must consist of at least 60-minute checks conducted in person. Staff must sign the chronological suicide watch logbook in use upon conducting checks.”	PS 5332.01 at p. 25
Video does not replace those checks	“The use of video observation for observers does not replace the need for physical hourly rounds to be conducted to check on the Suicide Watch Companions.”	PS 5332.01 at p. 17
Expected staff response	“The expected response time for staff to get to the suicide watch area is within three minutes.”	PS 5332.01 at p. 25
Psychologist contact	“The inmate will be seen in-person by a psychologist at least once per day, including weekends and holidays.”	PS 5332.01 at p. 16
Medical contact	“The HSA ensures that inmates on suicide watch are seen daily by a Health Services provider.”	PS 5332.01 at p. 4
Custody and duty-officer contact	“Correctional Services supervisors or designees, Institution Duty Officers (IDOs) and medical providers will also have daily contact with inmates on suicide watch and be responsive to needs that may arise.”	PS 5332.01 at p. 16
Every other department	Executive Staff, Chaplains, Education, Unit Management, Recreation and other responsible disciplines “make initial contact within 48-hours and provide follow-up as needed, but at a minimum once weekly following the initial contact.”	PS 5332.01 at p. 16
Everyone logs	“All staff making contact with the inmate on watch must document their interaction in the suicide watch observation log.”	PS 5332.01 at p. 16
Showering	“It is recommended that the individual on suicide watch be offered an opportunity to shower within 24 hours of their placement on observation, regardless of the day of the week.”	PS 5332.01 at p. 17

There is no “staggered interval” option in this policy, and no camera-only watch. That is the headline change from the 2007 edition: observation is continuous, direct and in person, and the 15-minute figure is the logging interval, not the looking interval. If a family is told their relative is being monitored by camera on a suicide watch, that is inconsistent with the Bureau’s own current instruction, and it is worth saying so, in writing, to the Chief Psychologist and the Warden.

The assessment clock

What	The Program Statement’s own words	Pin-cite
Before anyone is assessed	“Safety precautions (i.e., constant visual observation or suicide watch) must be implemented immediately and until Psychology Services conducts a formal SRA.”	PS 5332.01 at p. 11
Being seen after a referral	“During regular working hours, inmates referred for assessment of suicide potential will be seen by a psychologist as soon as feasible, but no longer than within 24 hours of the referral.”	PS 5332.01 at p. 12
Same, restated	“The inmate must be seen within 24 hours of referral.”	PS 5332.01 at p. 11
After hours	“During non-regular working hours, the on-call psychologist will consult with institution staff and may choose to see the inmate immediately or have the inmate placed on suicide watch… In either case, the inmate will be seen in person for a formal SRA within 24 hours of referral.”	PS 5332.01 at p. 12
Assessment on placement	“Every inmate being placed on suicide watch must be seen for a SRA. This SRA must be completed and documented within 24 hours of notification to Psychology Services of the individual’s placement on suicide watch.”	PS 5332.01 at p. 14
Finalizing the document	The SRA is ordinarily completed in the electronic health record within 24 hours; where another psychologist reviews it, “[t]he supervisor then has three working days to finalize the SRA.”	PS 5332.01 at p. 12
Long watches	“When an inmate has been on suicide watch for 72 hours and may require a medical center or advance care level referral, a psychologist will contact the Regional Psychology Services Administrator who will consult with the NSPC to discuss the case and determine if a transfer is appropriate.”	PS 5332.01 at p. 26

“SRA” is the Suicide Risk Assessment — the formal clinical evaluation. The contents the policy directs it to carry are listed at p. 13 and include the classification of the behavior, a lethality assessment, mental health and self-directed violence history, current mental status, a narrative weighing risk and protective factors, diagnosis, and recommendations. The policy also names the triggers, at p. 13: a staff referral, written or verbal communication suggestive of suicide, behavior suggestive of suicide, “[a]ny instance of SDV,” or any other condition leading the psychologist to believe an assessment is warranted. “SDV” is self-directed violence.

Who can start a watch, and who can end it

The asymmetry here is the single most useful thing on this page for anyone trying to get someone off a watch, or onto one.

Decision	Who holds it	Pin-cite
Reporting a concern	“All staff members who observe unusual behavior or gather information indicative of possible suicide risk during normal working hours must report these concerns to Psychology Services, or to a supervisor (e.g., Lieutenant), immediately either in person or via live telephonic conversation.”	PS 5332.01 at p. 4
Never by message	“Electronic mail and voicemail messages are never an acceptable mode of communication regarding inmate suicide risk.”	PS 5332.01 at p. 4; repeated at pp. 9, 11
Starting a watch	“Any staff member may arrange, through the shift Lieutenant, to initiate a suicide watch pending a formal Suicide Risk Assessment (SRA) by a psychologist.”	PS 5332.01 at p. 4
The regulation’s version	“Staff who identify an inmate to be at risk for suicide will have the inmate placed on suicide watch.”	28 C.F.R. § 552.41(d); PS at p. 10
Ending a watch	“Once an inmate has been placed on suicide watch, this status may not be terminated under any circumstances without a psychologist performing a face-to-face, in-person evaluation. Only a psychologist has the authority to remove an inmate from suicide watch.”	PS 5332.01 at p. 19
Property inside the room	“A psychologist determines the type of personal property, bedding, clothing, and other items (e.g., reading materials) that may be allowed inside the suicide watch room, and this decision may not be modified by anyone other than a psychologist.”	PS 5332.01 at p. 16
Using inmate observers	“Only the Warden may authorize the use of inmate observers.”	28 C.F.R. § 552.42(b)(2); PS at p. 18
Restraints	“As outlined in the Program Statement Use of Force, Application of Restraints, and Firearms, placement in restraints to address instances of SDV is a decision that must be recommended by Correctional Services and approved by the Warden.”	PS 5332.01 at p. 20
Legal and special social visits	The Warden or designee “has the final decision-making authority on approval of visitations,” and “it is recommended a psychologist and the Captain are consulted”; approved visits “require constant observation, and use of a logbook by a staff observer must continue during the visits.”	PS 5332.01 at pp. 17, 20

So: a correctional officer can put someone on a watch tonight. Only a psychologist, in person, can take them off it. A unit manager, a lieutenant, an associate warden — none of them can end a watch or override the psychologist’s property decision. If you are told that “the unit” or “the shift” decided to change something inside a watch, that is the wrong decision-maker under this policy.

Conditions of confinement on a watch

The policy sets a floor here, and the floor is more protective than most people expect. PS 5332.01 at p. 15–16: “While on suicide watch, an inmate’s conditions of confinement will be the least restrictive necessary to ensure control and safety.”

On clothing and dignity, p. 16: “At a minimum, an individual should always be authorized undergarments while on suicide watch unless there is a clear clinical indication they are at imminent risk to use that item to engage in SDV. If clinical rationale indicates such, this should be clearly documented in the SRA or daily Suicide Watch Contact.” And: “As outlined in the Program Statement Special Housing Units, alternate clothing/linen (paper or plastic) is not authorized for inmates on suicide watch.”

For women, the 2026 edition is more specific still, at p. 10: “Women on suicide watch are always authorized undergarments unless there are a clear clinical rationale and evidence to support withholding these items in the current suicide watch.” Staff “will afford women placed on suicide watch access to feminine hygiene products to include regular-size tampons, super-size tampons, regular-size maxi pads with wings, super-size maxi pads with wings, and panty liners. These are not limited to a one-to-one exchange. Staff are required to offer these products daily and deliver these products upon request.” And: “Unless exigent circumstances arise, constant visual observation of women on suicide watch will always be provided by staff or Suicide Watch Companions of the same sex.” The same standards apply where a woman is placed on watch in a contracted non-Bureau bed. See Female Offender Manual (PS 5200.09).

On restrictions generally, the policy is explicitly anti-punitive. PS 5332.01 at p. 23: “These treatment plans are built around positive reinforcement/rewards because positive reinforcers increase future likelihood of a behavior. Negative reinforcers/punishments are not to be used. The only appropriate limitations to an inmate’s property and privileges recommended by Psychology Services staff are those deemed clinically necessary to restrict access to means for self-harm (e.g., razor restriction, safety garments and linens, alternative meals, pill line only medications).” And on treatment refusal, at p. 21: “Lack of desire for or refusal to participate in treatment is not a rationale for withholding care.”

The BP-A1183, Suicide Watch Property Authorization form is new with this edition. Under p. 16 it is “recommended” that the psychologist complete and sign it and post it “in a prominent location in the suicide watch area where it does not hinder the visibility of the inmate on watch and is easily accessible to the observer” — so that every staff member on the post knows what is authorized. It also records whether the person can safely have legal and special social visits.

One more provision, at p. 12, that families and defense counsel should know exists: “Ordinarily, an inmate that is served an incident report for SDV or a suicide attempt will not be placed in restrictive housing.” Discipline after a crisis is not supposed to route through the SHU. See Inmate Discipline Program and Special Housing Units.

The Suicide Watch Companion Program

Some watches are staffed by other incarcerated people — trained, paid, and supervised. The regulation permits it; the Warden authorizes it; Psychology Services runs it. The rules are unusually concrete.

Rule	The Program Statement’s own words	Pin-cite
Who may not serve	“Inmates who have been found to have committed a 100-level prohibited act within the last three years may not be selected as Suicide Watch Companions.”	PS 5332.01 at p. 23
Shift length	“A Suicide Watch Companion’s schedule may never include more than one four-hour shift during any 24-hour period. While Suicide Watch Companions should not be regularly scheduled for more than four hours in a 24-hour period, under exigent circumstances they may work up to five hours. A Suicide Watch Companion can never work more than five hours in a 24-hour period.”	PS 5332.01 at p. 24
Training frequency	“At a minimum, one three-hour training is required for all Suicide Watch Companions each quarter.” Quarterly trainings “must occur at least 30 days apart.” Attendance for the full duration is mandatory.	PS 5332.01 at p. 24
Before a first watch	“Newly selected Suicide Watch Companions must attend one complete quarterly training (three hours) prior to working a suicide watch.”	PS 5332.01 at p. 24
Pay	“Suicide Watch Companions will be paid. They are considered to be on an institution work assignment while attending training or observing an inmate on suicide watch. This work assignment must take precedence over any other work detail assignment… Companions are paid based on the hourly pay rate for their assigned work grade.”	PS 5332.01 at p. 24
First Step Act status	“The Suicide Watch Companion program is a First Step Act (FSA) approved program and as such, inmates participating in this program are eligible to receive incentives and benefits in accordance with FSA policy. Suicide Watch Companions can not be paid for their services using FSA funds.”	PS 5332.01 at p. 24
Supervision	“At no time will a Suicide Watch Companion be assigned to a suicide watch without adequate provisions for staff supervision or without the ability to obtain immediate staff assistance (i.e., a phone that calls directly to control).”	PS 5332.01 at p. 25
Where companions may not be used	“Suicide Watch Companions may not be used in any situation involving an inmate on hunger strike or in restraints.”	PS 5332.01 at p. 26
Separate logbooks	“Staff and Suicide Watch Companions will document in separate approved logbooks. An inmate companion will not document in a staff observer’s logbook.”	PS 5332.01 at p. 18
Debriefing the companion	Where a watch was potentially stressful or upsetting to companions, or role conflicts occurred, the coordinator “must schedule a debrief for companions who have been affected, ideally within two working days, but not to exceed five working days, of the end of the suicide watch.”	PS 5332.01 at p. 25

Psychology Services selects, trains, assigns and may remove companions; the Warden decides whether the institution has a program at all, with the approval of the Central Office Psychology Services Branch (p. 23). Nothing on this page says whether any individual can join such a program or earn anything from it — that is a discretionary institutional decision. On the pay mechanics generally, see Work and Performance Pay; on First Step Act incentives, First Step Act Time Credits.

Review after a serious attempt, and after a death

This edition builds a three-tier review structure, and the middle tier is brand new.

After a high-lethality attempt. PS 5332.01 at p. 27 creates the BP-A1182, Self-Directed Violence High Lethality Review: “In the event of a serious suicide attempt at an institution (e.g., an attempt that could have reasonably resulted in death and is categorized as ‘high lethality’ by the assessing psychologist on the SRA), the BP-A1182, Self-Directed Violence High Lethality Review form is utilized to conduct a local review of the incident. This is a multidisciplinary review process conducted under the direction of an Associate Warden and involving collaboration and input from the Captain, HSA, Unit Manager, Chief Psychologist, and any other department head with relevant information.” Completed reviews go to the Regional Director, Regional Psychology Administrator and the Psychology Services Branch “on at least a quarterly basis,” and are stored digitally by the institution (p. 28).

After a death. The Warden notifies the Regional Director and Central Office Executive Staff; the Chief Psychologist notifies the National Suicide Prevention Coordinator and the Regional Psychology Administrator (p. 28). Two provisions in that section are worth quoting exactly. First, at p. 28: “The need to perform life-saving measures takes top priority and should not be delayed or curtailed based on a presumption of death … or concerns about crime scene preservation.” Second, also p. 28: “In the event of an inmate death by suicide, no clinical documentation from Psychology Services should be added, altered, or completed after the death.” A Psychological Reconstruction follows, directed by the National Suicide Prevention Coordinator; the report is reviewed by the Office of General Counsel, Health Services and Correctional Programs, and “will ordinarily be routed within 120 days of the completion of the site visit” (p. 29).

Follow-up. “Within 60 days of receiving a Psychological Reconstruction report, the Warden prepares an Institution Response,” including “a comprehensive corrective action plan,” routed through the Regional Director (p. 29). If the Assistant Director has questions about that plan, “a follow-up Institution Response is submitted to the RSD AD within 30 days” (p. 29).

Institution-level review. New in this edition, at p. 30: “Risk Reduction Reviews will occur at institutions that experience two or more inmate deaths by suicide in two calendar years.” At a complex, each institution is ordinarily treated separately — two deaths at two different institutions in the same complex do not trigger a review; two at a single institution do. The review examines “adherence to reconstruction recommendations, physical safety, communication and interaction styles, provision and fidelity of evidence based mental health treatment, perceptions of the use of discipline and restrictive housing, the reporting and referring culture of the facility (e.g., is it caring), and facility staffing.”

Staff training intervals

Training	The interval	Pin-cite
All staff	“Suicide prevention training must be included in the Introduction to Correctional Techniques (ICT I and II) and AT curriculum at all sites.” (AT is Annual Training.)	PS 5332.01 at p. 6
Supplemental specialty training — Health Services providers, Lieutenants, Chaplains, Correctional Counselors	Conducted in person “approximately six months after the completion of AT.” A department head must submit a memorandum explaining any staff member unavailable through long-term absence.	PS 5332.01 at p. 6
SHU staff	In-person training conducted with Correctional Services staff assigned to the SHU, per the Special Housing Units program statement; the “only approved alternative to in-person training is for staff who are unexpectedly assigned to the SHU.” Records go to the Employee Development Manager “not to exceed three working days.”	PS 5332.01 at pp. 6–7
Mock suicide emergencies	“At a minimum, the Captain (or supervisory designee), HSA (or designee), and Chief Psychologist (or licensed designee) will jointly conduct at least three mock suicide emergencies yearly, one on each shift, approximately four months apart.”	PS 5332.01 at p. 7
Where those drills happen	“Within the calendar year, two of these exercises will be conducted in the SHU and one in another inmate area… One of the SHU exercises must be conducted on Evening Watch or Morning Watch.”	PS 5332.01 at p. 7
Institutions with no SHU	“Institutions that do not have a SHU (e.g., Federal Prison Camps) are exempt from this aspect of the requirement but are still required to conduct three mock suicide emergencies yearly, one on each shift.”	PS 5332.01 at p. 7
Suicide Watch Companions	One three-hour training per quarter, quarters at least 30 days apart, full attendance mandatory.	PS 5332.01 at p. 24

The policy also directs certain staff to carry a rescue tool at all times. PS 5332.01 at p. 8: “The following staff at all security levels are required to obtain a cut-down tool from a secure storage location (normally the Control Center) upon reporting for duty and carry it throughout their shift: Unit Management, staff who have an assigned office in a housing unit (e.g., Residential Drug Abuse Program [RDAP] staff), staff assigned to a custody post on a housing unit, all staff assigned to a SHU, Compound Officers, and Lieutenants.”

Applied Insight — Christopher Zoukis, JD, MBA, Managing Director: The record that decides most disputes about a suicide watch is the logbook, and almost nobody asks for it in time. Every observer entry, every staff contact, every hourly check on an inmate companion, every departmental visit — all of it is supposed to land in the suicide watch observation log, maintained by Psychology Services “as a secure document consistent with guidance in the Records and Information Disposition Schedule” (PS 5332.01 at pp. 16–18). The Suicide Risk Assessment and the Post Suicide Watch Report sit in the electronic health record. If something went wrong on a watch, the useful step is not a phone call — it is a dated, specific written request that identifies the institution, the dates, and the documents by name, submitted before retention schedules do their work.

What binds and what does not in PS 5332.01

This distinction decides what a reader can actually do with this policy, so it goes near the front rather than buried.

A Program Statement is the Bureau’s internal instruction to its own staff. It is not a regulation. The Supreme Court said so directly in Reno v. Koray, 515 U.S. 50 (1995), describing a Program Statement as “an internal agency guideline” that is “akin to an ‘interpretive rule’ that ‘do[es] not require notice and comment,'” though “still entitled to some deference” where it is a permissible construction of the statute. So when this page says the policy “directs staff” to do something, that is precise language, not hedging.

PS 5332.01 is unusual in this batch because it does have a regulation underneath it — and the policy marks the boundary typographically. Its page header reads: “Federal Regulations from 28 CFR: this type. Implementing instructions: this type.” In the PDF those are two different colors; in any text extraction the color is lost. That is why this page identifies the regulatory passages by their section numbers, which the Bureau also prints in the text (§ 552.40, § 552.41, § 552.42), and why each of the three sections above was verified independently against the Code of Federal Regulations rather than trusted from the extraction.

What binds is short: an institution must have a designated suicide watch room and a Program Coordinator; medical staff are to screen a newly admitted person for suicide risk, ordinarily within twenty-four hours; staff who identify someone at risk will have them placed on watch; a psychologist will clinically assess each person placed on watch; observers are to document significant observed behavior in a log book; only the Warden may authorize inmate observers; and the watch ends on clinical findings, either by removal or by transfer to a medical referral center. That is the whole of it.

Everything more specific — the 15-minute log entries, the three-minute response standard, the 60-minute checks on companions, the daily psychologist visit, the 24-hour assessment deadline, the exclusion of cameras as a primary method, the ban on using segregation cells as watch cells, the four-hour companion shift — is implementing instruction. It is the Bureau’s own published commitment, and a documented, dated departure from it is real evidence of what the institution said its practice was. It is not, by itself, a violation of a regulation, and a court will not enforce PS 5332.01 as though it were one.

If someone is contemplating a constitutional claim, the standard is demanding and worth knowing before hope is invested in it. Under Farmer v. Brennan, 511 U.S. 825 (1994), “a prison official cannot be found liable under the Eighth Amendment for denying an inmate humane conditions of confinement unless the official knows of and disregards an excessive risk to inmate health or safety; the official must both be aware of facts from which the inference could be drawn that a substantial risk of serious harm exists, and he must also draw the inference.” The Court also held that officials “who actually knew of a substantial risk to inmate health or safety may be found free from liability if they responded reasonably to the risk, even if the harm ultimately was not averted.” Negligence is not enough; a policy violation is not automatically deliberate indifference.

A word about what this firm does. We are a federal criminal defense, appellate and post-conviction practice. We do not bring wrongful-death or deliberate-indifference damages actions, and nothing on this page is an offer to. The routes described below — the administrative remedy ladder and the Federal Tort Claims Act process — are the ones we can point you to, and both are things a family can start themselves. A family that wants to pursue civil damages after a death in custody needs a lawyer who does that work, and should consult one promptly, because the deadlines are short and independent of anything BOP does.

What the suicide prevention policy means for you

If you are the person inside: tell any staff member

If you are in trouble right now, tell any staff member. You do not need a form and you do not need to wait for the psychologist. Under PS 5332.01 at p. 4, every staff member who observes concerning behavior or receives concerning information during working hours reports it to Psychology Services or a supervisor immediately, in person or by live telephone call, and “[a]ny staff member may arrange, through the shift Lieutenant, to initiate a suicide watch pending a formal Suicide Risk Assessment.” Email and voicemail are never acceptable for this, which is why saying it out loud to someone matters more than writing it down.

Know what you are entitled to expect once a watch starts. A psychologist sees you in person at least once a day, weekends and holidays included (p. 16). A Health Services provider sees you daily (p. 4). Someone from your unit team and other departments makes contact within 48 hours and at least weekly after that (p. 16). Undergarments are authorized unless a psychologist has documented a specific clinical reason otherwise (p. 16). Paper or plastic clothing is not authorized on a suicide watch (p. 16). A shower should be offered within 24 hours (p. 17). Only a psychologist, face to face, can take you off the watch (p. 19), and only a psychologist can change what you are allowed to have in the room (p. 16).

Know what does not follow from a watch. It is not a disciplinary sanction, it does not belong in a segregation cell (p. 15), and under p. 12, someone served with an incident report for self-directed violence or a suicide attempt is ordinarily not placed in restrictive housing. Refusing treatment does not entitle anyone to withhold care from you: “Lack of desire for or refusal to participate in treatment is not a rationale for withholding care” (p. 21). If any of that has gone wrong, write it down afterwards with dates — the routes are in Where people get stuck, below.

If you are the family member: what suicide watch covers

The first thing to understand is that “suicide watch” covers more ground than it sounds like. Since March 2026 the policy allows a watch for someone in acute psychiatric crisis who cannot safely be celled with another person, even where the psychologist has not found elevated suicide risk (p. 14). So the phrase does not always mean what you will assume it means. Ask the institution which it is; you may not get an answer, but the question is legitimate and it tells staff you know the policy.

The second thing is that you are a recognized source of information, and the Bureau says so in writing. PS 5332.01 at p. 12 directs each institution to encourage referrals by, among other things, “placing posters in the visiting room encouraging family members to communicate potential risk to Bureau staff.” If you have seen something — a change in tone, giving possessions away, a goodbye letter, a direct statement — call the institution and say it to a person. Ask for Psychology Services. If you cannot reach them, ask for the Operations Lieutenant, and then call the Warden’s office. Say clearly that you believe it is urgent. Follow up in writing afterwards so there is a record, but make the live call first: the Bureau’s own instruction is that email and voicemail are never acceptable for communicating suicide risk (pp. 4, 9, 11).

The third thing is that visits may still be possible. Under p. 16 the psychologist is consulted on placement “to determine if the individual on observation can engage in legal and special social visits safely,” and records that on the BP-A1183 form; the Warden or designee holds final approval, and approved visits continue under constant observation with a staff logbook (pp. 17, 20). Ask. A special visit during a crisis is a real thing that happens, and nobody will offer it if you do not raise it. See Visiting Regulations and Inmate Visitation.

Keep a dated log of every call: who you spoke to, what you said, what they said. Families are frequently the only party keeping a written chronology, and that chronology is what turns “nobody would help us” into a specific, dated account. Our general orientation for families is What Families Should Know About Federal Prison.

If you are counsel: suicide prevention

Three practical points. First, the record set is specific and named, and you should ask for it by name: the Suicide Risk Assessment, the daily Suicide Watch Contact notes, the Post Suicide Watch Report, the suicide watch observation logbook (staff and companion logbooks are separate — p. 18), the BP-A1183 property authorization, and, if a serious attempt occurred, the BP-A1182 Self-Directed Violence High Lethality Review. Where a death occurred, the Psychological Reconstruction report and the Warden’s Institution Response with its corrective action plan run on defined timelines (p. 29). Note that the reconstruction report is reviewed by the Office of General Counsel before finalization (p. 29), which will shape any privilege position the government takes.

Second, the Post Suicide Watch Report is the most useful single document for post-conviction work, because the contents the policy directs it to carry (pp. 19–20) include current mental status, the risk factors reassessed, which stabilized, the reason for removal, diagnosis, conclusions on acute and chronic risk, and recommendations. Chronic risk has a defined operational meaning in this policy — “two or more suicide attempts prior to the current assessment” (p. 14) — and someone identified as chronically at risk “should be considered for a care level designation of two (i.e., Care2-MH) or higher.” That is directly relevant to a designation argument, to a compassionate release motion resting on mental health, and to § 3553(a) mitigation. See Treatment and Care of Inmates with Mental Illness and Compassionate Release / Reduction in Sentence.

Third, set expectations about enforceability early. Under Koray, PS 5332.01 is an internal guideline; §§ 552.40–552.42 are the enforceable text and they are thin. Farmer sets a subjective-knowledge standard that policy non-compliance alone does not satisfy. The realistic levers for a client who is alive and in trouble are administrative: a written request to the Chief Psychologist, the remedy ladder, and — where the institution genuinely cannot meet the need — the transfer machinery the policy itself describes, including the 72-hour consultation trigger at p. 26 and Federal Medical Center referral at pp. 26–27. See Federal Medical Centers and Medical Designations and Care Levels.

What changed with Program Statement 5332.01

This is the newest suicide-prevention policy the Bureau has issued in nineteen years, and the change list is where the value is. PS 5332.01 rescinded PS 5324.08, Suicide Prevention Program (4/5/2007) — PS 5332.01 at p. 1. The policy also moved to a new number: what was in the 5324 series is now 5332.01, so any citation to “PS 5324.08” in a filing, an institution handbook, or another agency’s document is now a citation to a rescinded policy.

The Bureau’s own Summary of Changes, transcribed verbatim from PS 5332.01 at pp. 1–2 (the verbs are BOP’s):

– Requires two mock suicide emergencies be conducted in the Special Housing Unit (SHU) annually. – Requires the staff member conducting the initial social screening (as outlined in the Program Statement Intake Screening) to review the BP-A0519, Psychology Services Inmate Questionnaire (PSIQ) form during the social screening process. – Eliminates the Special Review Committee and establishes follow-up procedures to Psychological Reconstructions and Risk Reduction Reviews for institutions with recurring inmate suicides. – Requires all psychologists at institutions participate in an on-call rotation to address emergency referrals that may occur during non-business hours. – Discusses responsive interventions for special populations. – Removes requirement for an Institution Supplement at Medical Referral Centers (MRC). – Expands the definition of suicide watch to include the ability to place individuals with dysregulated behaviors on watch at the discretion of the treating mental health provider. – Disallows electronic monitoring (e.g., cameras) as a primary means of monitoring inmates on suicide watch. Any inmate on suicide watch must be monitored via direct visual observation. – Creates BP-A1182, Self-Directed Violence High Lethality Review and BP-A1183, Suicide Watch Property Authorization forms. – Adds requirements related to cut-down tools. – Removes specific references to a Bureau inmate management system and related codes. Staff must now refer to the Suicide Prevention page of the Bureau’s intranet site for guidance regarding this system and required codes for suicide prevention.

Four of those deserve unpacking, because they change what a reader should expect.

Cameras are out as a primary method. This is the most consequential single change. The 2026 text is categorical at p. 15 — “Under no circumstances can electronic monitoring (e.g., cameras) be used as the primary observation method” — and repeats it at p. 17 in the observer standards. Video may still be used to watch the observer, but “will not be used as a substitute for constant visual, in-person observation of the inmate,” and does not replace physical hourly rounds on companions (p. 17). If an institution is running a camera watch, that is inconsistent with current policy on its face.

A wider definition of “suicide watch.” The status now covers acute psychiatric dysregulation as well as suicide risk (p. 14), at the treating provider’s discretion. That expands access to a protective placement, and it also means the label carries less diagnostic information than it used to.

Two new forms, one of them a review trigger. BP-A1182 creates a local, multidisciplinary review after a high-lethality attempt — a level of scrutiny that previously existed only after a death. BP-A1183 puts the psychologist’s property decisions in writing and posts them where the observer can see them, which is the practical answer to the recurring complaint that different shifts applied different rules.

Reviews follow patterns, not just incidents. The old Special Review Committee is gone; in its place are structured follow-up procedures after a Psychological Reconstruction, plus Risk Reduction Reviews at any institution with two or more deaths by suicide in two calendar years (p. 30). The named review criteria include “the reporting and referring culture of the facility (e.g., is it caring), and facility staffing” — the Bureau naming staffing as a suicide-prevention variable in its own policy.

Two further currency notes. The statement no longer names a Bureau inmate management system, pointing staff to the intranet instead; where it does name systems, they are the EHR and the Psychology Advisory List in TRUSCOPE (pp. 2, 10), not the PDS/SENTRY vocabulary of older psychology policies. And it removed the Institution Supplement requirement at Medical Referral Centers, so there is no local supplement to request under this policy: “b. Institution Supplement. None” (p. 2).

Where people get stuck under the suicide prevention program

Four problems recur. Each has a route, and the route matters more than the complaint.

“He’s on suicide watch and nobody will tell me anything.” Medical and mental health information belongs to the patient, and staff will not disclose it to you without authorisation — that part is not obstruction. What you can do is push information in rather than pull it out: call Psychology Services and the Warden’s office, state what you have observed, and ask that it be documented. You can also ask the unit team for a welfare check and ask whether a special social visit or a legal visit can be arranged, which under pp. 16–17 and 20 is a real, contemplated option requiring the psychologist’s input and the Warden’s approval. If your relative wants you to have information, the release runs from them, through Psychology Services — see FOIA and Privacy Act Requests.

“The watch is being run off a camera,” or “one officer is watching three people.” Both are inconsistent with the current text: constant direct visual observation with no video as the primary method (pp. 15, 17), and one observer per person at ordinary institutions, no more than two at a medical referral center (p. 17). Put it in writing. The first step is an Inmate Request to Staff — form BP-A0148, universally called a “cop-out” — to the Chief Psychologist, quoting the page and the sentence; see Request to Staff. A family member’s equivalent is a dated letter to the Warden with a copy to the Regional Director. If that produces nothing, the formal ladder is the Administrative Remedy Program: BP-9 to the Warden, BP-10 to the Regional Director, BP-11 to the Office of National Inmate Appeals, under 28 C.F.R. part 542, subpart B. The deadline is short — 28 C.F.R. § 542.14(a) sets “20 calendar days following the date on which the basis for the Request occurred,” subject to an extension “[w]here the inmate demonstrates a valid reason for delay.” BOP publishes BP-A0148 but does not publish the BP-9, BP-10 or BP-11 forms; you get those from the unit team. See Administrative Remedy Program.

“They kept him on the watch for weeks,” or “they took him off too soon.” These are clinical judgments, and the policy places them with a psychologist alone (p. 19). The productive angle is not to argue the clinical call but to name the procedural steps attached to it. A prolonged watch has a defined consultation trigger at 72 hours, running to the Regional Psychology Services Administrator and the National Suicide Prevention Coordinator (p. 26), and where the decision is not to transfer, “the consultation and rationale for the decision must be documented in the EHR, along with specific plans for continuing to address the inmate’s treatment needs locally” (p. 26). A premature removal still calls for a Post Suicide Watch Report, whose contents the policy defines (pp. 19–20). Ask, in writing, whether the 72-hour consultation occurred and what the documented rationale was.

Something went badly wrong, and someone was seriously hurt or died. There are two administrative tracks, and they are different from each other. Complaints about conditions and treatment go through the administrative remedy ladder above. Claims for injury, death or property loss go under the Federal Tort Claims Act, on a Standard Form 95 / BP-A0943 filed with the Bureau’s regional office — not through a BP-9. The FTCA has its own statutory deadlines, which run independently of the grievance process, and missing them is generally fatal to the claim. See Federal Tort Claims Act for how that filing works. Exhaustion matters too if court is ever a possibility: under the Prison Litigation Reform Act, 42 U.S.C. § 1997e(a), no action may be brought about prison conditions until available administrative remedies are exhausted. “Exhaustion” means completing every level of the internal grievance ladder, on time, before filing. As stated above, this firm defends federal criminal cases and handles post-conviction relief; we do not bring civil damages actions arising from a death in custody, and a family considering one should consult a lawyer who does that work promptly.

Where the underlying problem is a designation, a mental health care level, or a transfer to a facility that can actually meet the need, the administrative path is necessary but rarely sufficient on its own. Those belong in a consult — see Federal Prison Consulting Services or contact us.

If you need help right now. Anyone in the United States can reach the 988 Suicide and Crisis Lifeline by calling or texting 988. It is free, confidential, and available at every hour. If you are worried about someone inside a federal prison, call that institution’s Psychology Services department and the Warden’s office directly, tell whoever answers what you have seen or been told, and — if it is urgent — say so plainly, in those words. Do not leave it on voicemail or send it only by email: BOP’s own policy states that “[e]lectronic mail and voicemail messages are never an acceptable mode of communication regarding inmate suicide risk” (PS 5332.01 at p. 4). Every institution’s main number is on its page in our Federal Bureau of Prisons directory.

Related BOP policy on suicide prevention

The paired information page is Mental Health Programs for Inmates — the plain-language walkthrough of what mental health care in federal prison actually looks like. It links back here for the rule.

Policies that meet this one directly: Treatment and Care of Inmates with Mental Illness (PS 5310.16) defines the CARE1-MH through CARE4-MH levels this statement refers to for chronic risk. Patient Care (PS 6031.06) governs the Health Services side, including the arrival screening this policy relies on and the life-saving-measures provision it cross-references. Special Housing Units (PS 5270.12) carries the single-cell approval rule, the SHU training obligation and the hygiene standards this statement borrows, with the plain-language version at Solitary Confinement and Special Housing Units. Hunger Strikes (PS 5562.05) matters because companions may not be used in a hunger-strike situation. Our explainers on the Psychology Services Manual (PS 5310.17) and Psychiatric Services (PS 6340.04) carry the framework and the medication side.

Special populations and accommodations: Female Offender Manual (PS 5200.09), Management of Aging Offenders (PS 5241.01), and Management of Inmates with Disabilities (PS 5200.06) — all three named at PS 5332.01 p. 10. PREA and Sexual Abuse Prevention (PS 5333.01) is the parallel screening system running on the same intake.

Routes and records: Administrative Remedy Program (PS 1330.18), Request to Staff (PS 5511.08), Federal Tort Claims Act (PS 1320.07), FOIA and Privacy Act Requests (PS 1351.05), Inmate Discipline Program (PS 5270.09) and Prison Disciplinary Infractions for the incident-report question, Unit Team and Program Review (PS 5321.09) for who your unit contacts are, and the federal prison intake process for where the arrival screening sits. Further reading on our site: What Rights Do Prisoners Have?, Mental Health and Solitary Confinement in Federal Prison, and the DOJ Inspector General report on federal prison deaths.

Frequently Asked Questions About the Suicide Prevention Program

---

Program Statement 5332.01 — full text

What follows is Program Statement 5332.01 exactly as the Bureau of Prisons published it, reproduced in full from the official PDF rather than summarized. Source: bop.gov/policy/progstat/5332_001-1.pdf.

5332.01 3/19/2026 Federal Regulations from 28 CFR: this type. Implementing instructions: this type. 1

U.S. DEPARTMENT OF JUSTICE Federal Bureau of Prisons

PROGRAM STATEMENT Suicide Prevention Program Approved by

William K. Marshall III Director, Federal Bureau of Prisons DPI RSD Number 5332.01 Date March 19, 2026

Summary of Changes Program Statement Rescinded:

• 5324.08 Suicide Prevention Program (4/5/2007) Changes:
• Requires two mock suicide emergencies be conducted in the Special Housing Unit (SHU) annually.
• Requires the staff member conducting the initial social screening (as outlined in the Program Statement Intake Screening) to review the BP-A0519, Psychology Services Inmate Questionnaire (PSIQ) form during the social screening process.
• Eliminates the Special Review Committee and establishes follow-up procedures to Psychological Reconstructions and Risk Reduction Reviews for institutions with recurring inmate suicides.
• Requires all psychologists at institutions participate in an on-call rotation to address emergency referrals that may occur during non-business hours.
• Discusses responsive interventions for special populations.
• Removes requirement for an Institution Supplement at Medical Referral Centers (MRC).
• Expands the definition of suicide watch to include the ability to place individuals with dysregulated behaviors on watch at the discretion of the treating mental health provider.
• Disallows electronic monitoring (e.g., cameras) as a primary means of monitoring inmates on suicide watch. Any inmate on suicide watch must be monitored via direct visual observation.
• Creates BP-A1182, Self-Directed Violence High Lethality Review and BP-A1183, Suicide Watch Property Authorization forms.
• Adds requirements related to cut-down tools.

5332.01 3/19/2026 Federal Regulations from 28 CFR: this type. Implementing instructions: this type. 2

• Removes specific references to a Bureau inmate management system and related codes. Staff must now refer to the Suicide Prevention page of the Bureau’s intranet site for guidance regarding this system and required codes for suicide prevention.

1. § 552.40 Purpose and scope.

The Bureau of Prisons (Bureau) operates a suicide prevention program to assist staff in identifying and managing potentially suicidal inmates. When staff identify an inmate as being at risk for suicide, staff will place the inmate on suicide watch. Based upon clinical findings, staff will either terminate the suicide watch when the inmate is no longer at imminent risk for suicide or arrange for the inmate’s transfer to a medical referral center or contract health care facility.

a. Program Objectives.

• All Bureau staff will be trained to recognize signs and evidence that may indicate elevated risk for death by suicide by attending Introduction to Correctional Techniques I and II (ICT I and ICT II) and Annual Training (AT) thereafter.
• Staff will act to prevent deaths by suicide with appropriate sensitivity, supervision, and referrals consistent with clinical and correctional best practices.
• Any inmate found to be at risk for self-directed violence (SDV) will receive appropriate preventative supervision, assessment, and treatment.

b. Institution Supplement. None.

2. RESPONSIBILITIES FOR BUREAU FACILITIES AND SERVICES

a. Psychology Services Branch (PSB). The Central Office PSB is part of the Reentry Services

Division (RSD), and provides oversight and consultation regarding institution treatment and care of potentially suicidal inmates through remote reviews of Electronic Health Record (EHR) documentation; recommendations regarding transfers and designations of potentially suicidal inmates; and direct consultation with Chief Psychologists, other psychologists, and institution Executive Staff.

The National Suicide Prevention Coordinator (NSPC), PSB, is the Bureau’s primary source and point of contact on suicide prevention programs, research, assessment, and intervention. The NSPC provides oversight for the Bureau’s inmate suicide prevention program, developing various training modules for staff, including Introduction to Correctional Techniques (ICT), AT, supplemental suicide prevention training, quarterly SHU training, and materials and training in support of the clinical development of Bureau psychologists (e.g., remote training, Brief Cognitive Behavioral Therapy for Suicide at the National Corrections Academy).

The NSPC directs Psychological Reconstructions of inmate suicides. They develop an annual

5332.01 3/19/2026 Federal Regulations from 28 CFR: this type. Implementing instructions: this type. 3

report on the state of suicide prevention in the Bureau and are responsible for developing a research-based foundation for the Bureau’s suicide prevention program.

b. Wardens. Each Warden is responsible for the appropriate management of potentially

suicidal inmates in their institution. They must ensure Psychology Services is adequately staffed to meet all expectations of this program statement and the department has adequate time, space, and material resources to educate staff about detecting and reporting any unusual inmate behaviors that might suggest suicide risk. If Psychology Services staffing is temporarily too low to ensure appropriate training and care, Wardens consult with Regional Psychology Services Administrators to arrange for Temporary Duty (TDY) assignments from PSB and/or coverage from nearby institutions. In addition, the Warden authorizes the use of Suicide Watch Companions as appropriate.

c. Institution Chief Psychologists. Each Chief Psychologist ensures the provisions of this

program statement are implemented, including designation of a psychologist to serve as the local Suicide Prevention Program Coordinator (SPPC). The Chief Psychologist ensures information about the availability of suicide prevention services is disseminated to inmates during Admission and Orientation (A&O) using the A&O lesson plan developed by the PSB and communicating with the inmate population as deemed appropriate via TRULINCS, walking and talking, impromptu unit meetings, bulletin boards, town hall meetings, etc.

The Chief Psychologist is responsible for ensuring psychological services are provided to inmates as detailed in the Program Statement Treatment and Care of Inmates with Mental Illness, and a psychologist is always on call to address emergency referrals that may occur during non-business hours. When local psychologist coverage cannot be provided (e.g., due to illness, injury, leave, low staffing), arrangements will be made between the Chief Psychologist, Regional Psychology Administrator, Associate Warden, and other institutions in the general vicinity to provide appropriate coverage.

d. § 552.41 Program procedures.

(a) Program Coordinator. Each institution must have a Program Coordinator for the institution’s suicide prevention program. (b) Training. The Program Coordinator is responsible for ensuring that appropriate training is available to staff and to inmates selected as inmate observers. Suicide Prevention Program Coordinator (SPPC). The SPPC is a licensed doctoral-level psychologist or a psychologist who is under the supervision of a licensed psychologist who oversees and implements the Suicide Watch Companion Program and assists with departmental compliance with suicide prevention-related policy requirements by performing perpetual audits or other quality assurance activities. The SPPC will maintain expertise in the identification, assessment, and treatment of individuals who engage in SDV and who may be at risk for suicide.

5332.01 3/19/2026 Federal Regulations from 28 CFR: this type. Implementing instructions: this type. 4

The SPPC serves as a resource to provide or consult with other psychologists about the provision of staff training on suicide prevention.

e. Psychologists. All psychologists are responsible for recognizing and assessing suicide risk, providing clinical treatment and administrative oversight to inmates on suicide watch, and implementing mental health interventions to address risk factors for suicide and underlying mental health conditions. Psychologists are required to document clinical information in the EHR so the information is readily available for continuity of care. All psychologists are required to participate in an on-call rotation to address emergency referrals that may occur during non-business hours.

f. Health Services Administrator (HSA). Health Services organizes, conducts, administers,

and maintains responsibility for psychiatric services. In facilities that use contract psychiatric services, the HSA is responsible for contract development and oversight. In facilities that do not employ or contract with a Psychiatrist or Psychiatric Advanced Practice Provider, the HSA is responsible for arranging use of Bureau telepsychiatry services and prioritizing referrals for inmates at risk for suicide or SDV. The HSA ensures a staff member from Health Services is assigned to escort contractors and supervise inmates in telepsychiatry appointments. The HSA ensures that inmates on suicide watch are seen daily by a Health Services provider. The HSA, in coordination with the Chief Psychologist, ensures regular interdisciplinary communication is maintained between Psychology Services and Health Services staff, to coordinate care and reconcile diagnostic differences.

g. Clinical Director. The Clinical Director ensures potentially suicidal inmates receive

appropriate medical and psychiatric assessment and treatment. The Clinical Director ensures emergency medication is provided consistent with the Program Statement Psychiatric Services and guidance disseminated by the Bureau’s Medical Director. The Clinical Director also ensures referrals for psychiatric medication evaluations result in an evaluation for medical need by local or remote providers.

h. Bureau Staff. All staff members who observe unusual behavior or gather information

indicative of possible suicide risk during normal working hours must report these concerns to Psychology Services, or to a supervisor (e.g., Lieutenant), immediately either in person or via live telephonic conversation. During regular normal working hours staff should contact Psychology Services directly, and if there is no response contact a supervisor. During non-regular working hours staff will contact a supervisor (e.g., Lieutenant) who will consult with the on-call psychologist. Electronic mail and voicemail messages are never an acceptable mode of communication regarding inmate suicide risk. Any staff member may arrange, through the shift Lieutenant, to initiate a suicide watch pending a formal Suicide Risk Assessment (SRA) by a psychologist.

5332.01 3/19/2026 Federal Regulations from 28 CFR: this type. Implementing instructions: this type. 5

3. RESPONSIBILITIES FOR CONTRACT FACILITIES AND SERVICES

When inmates are housed outside of a Bureau facility, they may receive services from contractors. This is most common during the reentry process. When contracts for services are used, the Statement of Work will include a suicide prevention plan or program that meets American Correctional Association (ACA) standards.

a. Community Reentry Affairs Branch (CRB). The Community Treatment Services (CTS)

section of the CRB is responsible for the establishment and oversight of community-based mental health, substance use, and sex offender treatment services. CTS sets standards for community providers for the recognition of and appropriate response to individuals with a history of SDV (e.g., crisis intervention procedures). CTS is the primary office for collecting information from institution staff (e.g., Case Management Coordinator [CMC], Health Services, Unit Management, Psychology Services) about an inmate’s mental health needs (e.g., continuity of care for individuals subject to an elevated risk of SDV). CTS will consult with the PSB when there are complex cases and/or system-wide or interagency issues. They will work closely with the Residential Reentry Management Branch (RRMB) to facilitate placement in geographic locations with appropriate resources and connect individuals with those resources.

b. Residential Reentry Management Branch (RRMB). The RRMB is responsible for

collaborating with the CRB to coordinate placement for individuals at risk for suicide (e.g., history of SDV) releasing through Residential Reentry Centers (RRC) and Home Confinement. Residential Reentry Managers (RRMs) will monitor contract facilities regularly to determine their capability to manage at-risk populations effectively. The RRM will consult with CRB and the NSPC if questions arise about the adequacy of a contract facility’s suicide prevention program or about the need to transfer a potentially suicidal resident to a different facility. The RRM will contact the PSB when there are system-wide or interagency issues. In the event of a suicide, the RRMB will notify the NSPC and all evidence and documentation will be preserved to provide data and support for a subsequent Psychological Reconstruction, as outlined in Section 16 of this program statement.

c. Institution Psychology Services. Chief Psychologists are responsible for ensuring critical mental health information, specifically suicide risk (e.g., acute, chronic) and known destabilizing factors are communicated to Unit Management, CTS, and the RRMB for inmates who have received or are awaiting a designation to an RRC or home confinement. This is typically accomplished as described in Program Statement Treatment and Care of Inmates with Mental Illness. Acutely suicidal inmates are treated prior to transfer to an RRC or home confinement. Inmates with chronic suicide risk as identified in the EHR may be transferred to an RRC or home confinement and will require connection with community mental health providers.

5332.01 3/19/2026 Federal Regulations from 28 CFR: this type. Implementing instructions: this type. 6

4. TRAINING

While the initial period of incarceration is often a critical time for inmates, serious suicidal crises may arise at any time. Line staff are often the first to identify signs of potential suicidal behavior based on their frequent interactions with inmates. The Chief Psychologist is responsible for ensuring appropriate training is available to institution staff. The Chief Psychologist in conjunction with Executive Staff, department heads, and supervisors ensure all staff are trained, ordinarily by Psychology Services staff, to recognize signs indicative of potential suicide, the appropriate referral process, and suicide prevention techniques.

a. Training for All Staff. Suicide prevention training must be included in the Introduction to Correctional Techniques (ICT I and II) and AT curriculum at all sites. Training for staff will focus on:

• Suicide watch logbook documentation procedures.
• Maintaining basic conditions of suicide watch.
• Communicating with the inmate on suicide watch.
• Risk factors and warning signs for suicide.
• Recognition of potentially suicidal behavior.
• Common characteristics of inmates who have died by suicide.
• High-risk groups, locations, and circumstances.
• Lessons learned from Psychological Reconstructions.
• Identifying and referring suicidal inmates.
• Responding to a suicide emergency (e.g., suicide attempt in progress), including the location and proper use of a cut-down tool, initiation of life-saving measures, and use of an automatic external defibrillator (AED).
• Name of the SPPC, location of suicide watch rooms, etc.

b. Supplemental Specialty Training. The Chief Psychologist ensures in-person supplemental

training is offered to staff who have frequent contact with inmates. Supplemental specialty training is required to be conducted with Health Services providers (e.g., Medical Officers, Advanced Practice Providers [APPs], Paramedics, Registered Nurses, Dental Hygienists), Lieutenants, Chaplains, and Correctional Counselors approximately six months after the completion of AT. This training ordinarily occurs in person to facilitate discussion. If a department has a staff member who is not available for training due to long term absence, the department head must submit a memorandum to the SPPC indicating why this individual is not available to participate in required training.

c. Supplemental Training for Special Housing Unit (SHU) Staff. The Chief Psychologist

ensures in-person training is conducted with Correctional Services staff assigned to work in the SHU in accordance with Program Statement Special Housing Units. The only approved alternative to in-person training is for staff who are unexpectedly assigned to the SHU; they may

5332.01 3/19/2026 Federal Regulations from 28 CFR: this type. Implementing instructions: this type. 7

complete training on the Bureau’s electronic training platform (e.g., Bureau Learning University [BLU]). Training will focus on risks associated with the SHU environment, reviewing risk factors and warning signs for suicide, identifying local inmates at risk for suicide and SDV, the risks associated with single cell housing, and determining strategies to reduce risk. Training information is provided to the Employee Development Manager in a timely manner (e.g., not to exceed three working days) for inclusion in the staff electronic training records. In addition, information about recognizing potentially suicidal inmates and procedures to follow will be included in all SHU post orders. Psychology Services staff can access a sample suicide prevention information SHU addendum to post orders on the PSB page of the Bureau’s intranet site.

d. Emergency Response Training. At a minimum, the Captain (or supervisory designee), HSA

(or designee), and Chief Psychologist (or licensed designee) will jointly conduct at least three mock suicide emergencies yearly, one on each shift, approximately four months apart. Complexes will complete the exercises separately at each institution within the complex. These exercises are interactive, live-action role plays that require staff to physically simulate and problem-solve the actions of responding to a suicide attempt in progress (e.g., calling for assistance, responding to the scene, taking appropriate safety precautions, using the cut-down tool, initiating life saving measures, applying the AED).

Within the calendar year, two of these exercises will be conducted in the SHU and one in another inmate area (e.g., general housing unit, work detail site, Receiving and Discharge [R&D], Health Services, Food Services). One of the SHU exercises must be conducted on Evening Watch or Morning Watch.

Institutions that do not have a SHU (e.g., Federal Prison Camps) are exempt from this aspect of the requirement but are still required to conduct three mock suicide emergencies yearly, one on each shift (i.e., Morning Watch, Day Watch, and Evening Watch).

Documentation of training will be completed by memorandum from Psychology Services to the appropriate Associate Warden. Psychology Services staff can refer to the PSB page of the Bureau’s intranet site to access a sample memorandum for documenting mock suicide emergency training. All training documentation is maintained by Psychology Services, with copies to Correctional Services, Health Services, and Employee Development. The Chief Psychologist is responsible for reporting the completion of each mock drill to the Regional Psychology Services Administrator. The Regional Psychology Services Administrator will provide the dates of mock drills completed at each institution in their region to the PSB Chief of Mental Health at the completion of each calendar year.

One mock suicide scenario may be done as a component of an institution major mock exercise. If this option is selected, the Chief Psychologist collaborates with the Captain to ensure a mock suicide emergency is incorporated into the overall major mock scenario in a manner that affords

5332.01 3/19/2026 Federal Regulations from 28 CFR: this type. Implementing instructions: this type. 8

meaningful participation and training for staff from a variety of disciplines, including Psychology Services, Health Services, Correctional Services, and first responders from other departments.

This training is in addition to the supplemental specialty training for Health Services providers, Lieutenants, Correctional Counselors, and Chaplains. It will include a component to ensure cut-down tools, AEDs, and gurneys/stretchers/backboards are readily available to the location, and these items arrive on scene in an efficient and timely manner.

The following staff at all security levels are required to obtain a cut-down tool from a secure storage location (normally the Control Center) upon reporting for duty and carry it throughout their shift: Unit Management, staff who have an assigned office in a housing unit (e.g., Residential Drug Abuse Program [RDAP] staff), staff assigned to a custody post on a housing unit, all staff assigned to a SHU, Compound Officers, and Lieutenants.

Cut-down tools are to be carried by the assigned staff member in a way that secures it to the staff duty belt or vest (i.e., in an approved holster).

5. IDENTIFICATION OF INMATES AT RISK FOR SUICIDE UPON ARRIVAL

a. Health Services Screening.

§ 552.41 Program procedures. (c) Identification of at risk inmates. (1) Medical staff are to screen a newly admitted inmate for signs that the inmate is at risk for suicide. Ordinarily, this screening is to take place within twenty-four hours of the inmate’s admission to the institution. In accordance with the Program Statement Patient Care, Health Services clinical staff conduct an initial assessment of each newly committed inmate upon their arrival at an institution. This screening is to determine, in part, urgent mental health care needs. Inmates with perceived urgent mental health care needs, including but not limited to current risk for suicide, are referred to Psychology Services immediately. If this occurs after hours and it involves risk for suicide, contact the Operations Lieutenant, initiate a suicide watch, and contact the on-call psychologist. For all other acute mental health concerns, contact and consult with the on-call psychologist.

b. Pretrial and Presentence Detainees. Per the Program Statement Psychology Services

Manual, inmates arriving at pre-trial facilities (e.g., Metropolitan Correctional Center [MCC]) or institutions with similar missions, are required to complete the BP-A0519, Psychology Services Inmate Questionnaire form, or PSIQ, within 24 hours of arrival. This form will be completed in R&D upon arrival in conjunction with the initial Health Services screening and social screening.

5332.01 3/19/2026 Federal Regulations from 28 CFR: this type. Implementing instructions: this type. 9

c. Per the Program Statement Intake Screening, a social screening is required to be conducted

immediately upon each inmate’s arrival to determine, in part, the emotional condition of the inmate. Ordinarily, the social screening is conducted by a staff member from Unit Management. However, the Warden may designate other staff who have been trained in intake screening, particularly Correctional Services staff, to conduct interviews of inmates arriving outside of regular business hours. The staff member conducting the social screening reviews the completed PSIQ to determine if the inmate has answered “yes” to item #7, “Are you thinking of harming or killing yourself now?” If the answer to item #7 is “yes,” the staff member will notify Psychology Services immediately via telephonic communication or in person. Email or voicemail/other telephonic message notification for this is never acceptable.

After reviewing PSIQs, the staff member completing social screenings leaves the PSIQs in a secure, mutually agreed-upon location for retrieval by Psychology Services.

6. IDENTIFICATION OF INMATES AT RISK FOR SUICIDE AFTER ARRIVAL

a. Newly Assigned and Transferred Inmates. As outlined in the Program Statement

Psychology Services Manual, provisions are in place for psychological intake screenings of newly assigned and transferred inmates within 14 or 30 days of arrival, respectively. Prior to the inmate leaving the screening area, the staff member (i.e., ordinarily, a staff member from Unit Management or designee) responsible for conducting the initial screening reviews the PSIQ to determine if the inmate has answered “yes” to item #7, “Are you thinking of harming or killing yourself now?” or if there is any other information suggestive of suicide or SDV risk. If the answer to item #7 is yes, or if there is any other information suggestive of suicide or risk of SDV, the staff member conducting the screening will notify Psychology Services immediately via telephonic communication or in person. Email or voicemail/other telephonic message notification for this is never acceptable.

When information suggestive of suicide risk or SDV is communicated to Psychology Services (e.g., via Health Services intake screening, social screening, self-referral, or other staff or inmate referral) prior to the completion of the psychological intake screening, a formal SRA is required, and completion of the intake screening is prioritized.

b. Inmates in Restrictive Housing. Inmates in restrictive housing, particularly those requesting protective custody (PC) or requesting to be celled alone, are at increased risk for SDV and suicide. Correctional Services staff must carefully observe inmates for suicide risk factors and warning signs. Psychology Services works closely with Correctional Services staff to monitor inmates for signs of hopelessness, anxiety, agitation, depression, psychosis, or any mental health symptom suggesting a need for an increased level of psychology services. If a SHU inmate exhibits emotional distress or warning signs of suicide, Correctional Services will notify Psychology Services immediately.

5332.01 3/19/2026 Federal Regulations from 28 CFR: this type. Implementing instructions: this type. 10

c. Inmates Requiring Special Precautions. The Psychology Advisory List (PAL) in

TRUSCOPE provides information about inmates who may become unstable, dangerous, self-injurious, or suicidal when placed in restrictive housing due to a mental health condition. The Chief Psychologist will ensure the PAL is updated as needed with current, accurate information. When an inmate on the PAL is placed into restrictive housing, a Lieutenant will notify Psychology Services immediately, in person or telephonically. Psychology Services will see an inmate on the PAL within the time frames outlined in the Program Statement Special Housing Units. Information regarding that inmate may be copied from TRUSCOPE into the SHU Program for local review during SHU meetings.

d. Special Populations. Certain populations, including women, inmates who are aging or

elderly, or inmates who have a disability, may present with unique risk factors and warning signs for suicide and may require special considerations and accommodations related to the assessment, management, and treatment of suicide risk. Psychologists involved in the care of inmates who belong to any special population will consult with an appropriate subject matter expert in the Women and Special Populations Branch to ensure ethical practice. Upon consultation, appropriate accommodations must be provided in accordance with Program Statements Female Offender Manual and Management of Inmates with Disabilities.

In accordance with the Program Statement Female Offender Manual, the needs of women placed on suicide watch will be addressed in a manner responsive to the needs of women. Women on suicide watch are always authorized undergarments unless there are a clear clinical rationale and evidence to support withholding these items in the current suicide watch (e.g., current or past documentation of SDV attempts using these items). Staff will afford women placed on suicide watch access to feminine hygiene products to include regular-size tampons, super-size tampons, regular-size maxi pads with wings, super-size maxi pads with wings, and panty liners. These are not limited to a one-to-one exchange. Staff are required to offer these products daily and deliver these products upon request. Unless exigent circumstances arise, constant visual observation of women on suicide watch will always be provided by staff or Suicide Watch Companions of the same sex. For institutions using contract beds at non-Bureau facilities to place women offenders on suicide watch, the standards described above are required as well.

e. § 552.41 Program procedures.

(c) Identification of at risk inmates. (2) Staff (whether medical or non-medical) may make an identification at any time based upon the inmate’s observed behavior. (d) Referral. Staff who identify an inmate to be at risk for suicide will have the inmate placed on suicide watch.

f. Safety Precautions and Referral. Any staff member may identify an inmate as potentially

5332.01 3/19/2026 Federal Regulations from 28 CFR: this type. Implementing instructions: this type. 11

suicidal at any time based upon the inmate’s verbal or written communication or observed behavior. Whenever staff determine there is concern related to current suicide potential, Psychology Services will be notified immediately in person or by telephone call. Email and voicemail messages are not acceptable under such circumstances. Safety precautions (i.e., constant visual observation or suicide watch) must be implemented immediately and until Psychology Services conducts a formal SRA. Documentation must be completed in accordance with the Program Statement Psychology Services Manual. Ordinarily, when Psychology Services is at the institution during day watch hours, an inmate will be kept under constant visual observation until Psychology Services arrives to assess the individual and determine if suicide watch is necessary. The inmate must be seen within 24 hours of referral. During non-business hours, notification will be made to the on-call psychologist, ordinarily by the Operations Lieutenant.

7. RESTRICTIVE HOUSING CUSTODIAL ISSUES

a. Single Cell Status. Being housed alone is a strong predictor of death by suicide. Absent

written approval from the Warden as described in Program Statements Special Housing Units, inmates in SHU will be celled with a cellmate.

b. Psychology Services. At a minimum, a psychologist will make weekly rounds of restrictive

housing units, documented by their signature in the unit logbook. As a component of these rounds, they will consult with staff in those units concerning any inmates needing special attention.

c. Health Services. During required daily rounds of restrictive housing units, the Health

Services Clinical Director, or their designee, will be attentive to inmates whose risk for SDV or suicide may become elevated due to changes in health status or medication needs. Health Services will immediately notify Psychology Services and restrictive housing unit staff when these concerns are identified. When an inmate demonstrates medication refusal, particularly when such refusal could create the potential for the inmate to become unstable, dangerous, self-injurious, or suicidal, Health Services will collaborate with Psychology Services to attempt to improve compliance or identify alternatives.

d. Inmate Removal from Restrictive Housing. Inmates will be removed from restrictive

housing to be placed on suicide watch when exhibiting elevated potential for suicide. Ordinarily, once the crisis is over or it is determined they no longer have an elevated suicide risk, inmates are returned to restrictive housing. However, when Psychology Services determines placement in restrictive housing contributes to heightened risk for suicide or SDV, alternative housing arrangements will be considered in consultation with Correctional Services, the Executive Staff, Regional Psychology Administrator and, as appropriate, PSB.

5332.01 3/19/2026 Federal Regulations from 28 CFR: this type. Implementing instructions: this type. 12

e. Prevention of Placement in Restrictive Housing. As outlined in the Program Statement

Treatment and Care of Inmates with Mental Illness, an inmate’s mental health symptoms may contribute to institution rule infractions that could result in disciplinary sanctions, including placement in restrictive housing. Psychology Services and Correctional Services will collaborate to prevent placement in restrictive housing for behaviors resulting from mental health symptoms. Ordinarily, an inmate that is served an incident report for SDV or a suicide attempt will not be placed in restrictive housing.

8. IDENTIFICATION OF INMATES AT RISK OF SUICIDE BY NON-STAFF

MEMBERS

In addition to staff, the inmate’s community and family members are a vital resource in helping to prevent inmate death by suicide. To facilitate this process each institution will encourage referrals by:

• including a section in the institution inmate handbook/orientation materials encouraging inmates to notify staff of any behavior or situation that may suggest an inmate is in distress and may be considering suicide,
• incorporating the topic of inmate referrals into the A&O lesson plan for Psychology Services,
• placing posters in each housing unit addressing the topic in English and Spanish, and
• placing posters in the visiting room encouraging family members to communicate potential risk to Bureau staff.

9. SUICIDE RISK ASSESSMENT OF IDENTIFIED INMATES

§ 552.41 Program procedures.

(e) Assessment. A psychologist will clinically assess each inmate placed on suicide watch.

During regular working hours, inmates referred for assessment of suicide potential will be seen by a psychologist as soon as feasible, but no longer than within 24 hours of the referral. Constant visual observation of the inmate must be maintained until a formal SRA can be completed by a psychologist. During non-regular working hours, the on-call psychologist will consult with institution staff and may choose to see the inmate immediately or have the inmate placed on suicide watch. It is important to note that constant visual observation of the inmate must be kept until a psychologist has made a determination of suicide risk for that particular inmate. In either case, the inmate will be seen in person for a formal SRA within 24 hours of referral. Ordinarily, the SRA will be completed in the EHR within 24 hours of the incidents outlined below. In instances where the SRA is to be reviewed by another psychologist, the document must be submitted to the review queue within 24 hours of the incidents outlined below. The supervisor then has three working days to finalize the SRA.

5332.01 3/19/2026 Federal Regulations from 28 CFR: this type. Implementing instructions: this type. 13

An SRA will be completed when:

• Staff refer an inmate to Psychology Services because the inmate may be at risk for suicide.
• An inmate’s written or verbal communication is suggestive of suicide.
• An inmate exhibits behavior suggestive of suicide (e.g., the inmate refuses/gives away their property).
• Any instance of SDV.
• Any other condition is present that would lead the psychologist to believe that an SRA is warranted.

At a minimum, the SRA includes:

• Type of housing and cell accommodation.
• Classification of suicide-related behaviors.
• Lethality assessment.
• Reason for referral, including date and time of referral and date and time of the SRA, identification of initial referral source, and details resulting from interviewing the initial referral source.
• Mental health and SDV history.
• Current problem, including case conceptualization.
• Current mental status.
• Narrative of risk and protective factors assessed, which weighs risk and protective factors in support of the decision to initiate or not initiate suicide watch.
• An explanation of why some risk or protective factors were not assessed.
• Diagnosis.
• Recommendations, which include social, environmental, and clinical interventions; if no clinical recommendations are made, a clear rationale for this decision is required.

During an SRA, psychologists are required to make several complex determinations based on the totality of information gleaned from an SRA. Thoughts, threats, and acts of violence toward others and self should be considered when evaluating risk of suicide. Psychologists should also consider stability of thoughts, escalation of behaviors, and recency of said thoughts and behaviors when documenting the conceptualization of suicide risk. Interventions are then based on the documented and transparent conceptualization of risk factors. It is recognized that the risk of suicide is dynamic and may change rapidly or over time, resulting in changes to the planned interventions. Decision-making considerations should be clear within the documentation of risk factors noted in the SRA. a. Lethality. Assessment of lethality refers to an estimate of the likelihood of death resulting from an inmate’s self-injurious actions or plans. Some self-injurious behaviors may be estimated as having low lethality when they are unlikely to result in injury or death, such as making a superficial cut on one’s wrist in the presence of staff. Other self-injurious behaviors may be

5332.01 3/19/2026 Federal Regulations from 28 CFR: this type. Implementing instructions: this type. 14

estimated to reflect moderate lethality because they could or did result in injury and/or efforts were made to obscure the behavior from others. Finally, self-harm behavior may be considered to have high lethality if it could have resulted in death, such as a suicide attempt in a private area with no expectation of immediate intervention or life-saving measures.

When self-harm behaviors or plans are determined to be of low lethality, it should not automatically be concluded that acute suicide risk is low. However, it is appropriate to conceptualize behaviors or plans of moderate or high lethality as indicative of elevated acute risk of death by suicide in the absence of suicidal ideation.

b. Acute Risk. Acute risk refers to an inmate’s potential for imminent self-harm. Psychologists estimate acute risk as low, moderate, or high based on their analysis of the information gleaned during the SRA. Acute risk is particularly determined by current dynamic risk factors such as hopelessness, depression, and agitation.

c. Chronic Risk. Chronic risk refers to an inmate’s potential for death by suicide based on their history. Chronic risk has been operationalized as two or more suicide attempts prior to the current assessment. Chronic risk is determined to be either present or absent, based on history. Inmates identified as being at chronic risk for suicide should be considered for a care level designation of two (i.e., Care2-MH) or higher. See the Program Statement Treatment and Care of Inmates with Mental Illness for additional recommendations in the management and documentation of inmates with chronic suicide risk.

10. ENVIRONMENTAL INTERVENTIONS

§ 552.41 Program procedures.

(f) Intervention. Upon completion of the clinical assessment, the Program Coordinator or designee will determine the appropriate intervention that best meets the needs of the inmate.

a. Suicide Watch. Suicide watch may be used for individuals who have an increased risk of

suicide or increased need for support and observation due to acute mental illness (i.e., individuals who present with psychosis or significant behavioral dysregulation related to mental health concerns and cannot be celled with another person but does not present with increased risk factors for death by suicide). Every inmate being placed on suicide watch must be seen for a SRA. This SRA must be completed and documented within 24 hours of notification to Psychology Services of the individual’s placement on suicide watch. Upon completion of an SRA incorporating an analysis of risk and protective factors, lethality of plans or behaviors, the degree of acute risk (low, moderate, or high), and the presence or absence of chronic risk, the psychologist must determine what interventions best meet the specific safety and treatment needs of the individual inmate. Inmates determined to be at moderate or high acute risk for suicide or

5332.01 3/19/2026 Federal Regulations from 28 CFR: this type. Implementing instructions: this type. 15

potentially lethal self-harm behaviors should ordinarily be placed on suicide watch for suicide risk. If inmates do not present with significant suicide risk, but their functioning in general population or in restrictive housing is severely compromised, they may also be placed on suicide watch. Regardless of the reason for suicide watch, cell conditions will often look similar.

(1) § 552.42 Suicide watch conditions.

(a) Housing. Each institution must have one or more rooms designated specifically for housing an inmate on suicide watch. The designated room must allow staff to maintain adequate control of the inmate without compromising the ability to observe and protect the inmate.

The room(s) must permit easy access, privacy, and unobstructed vision of the inmate at all times. It may not have fixtures or architectural features that would easily allow self-injury to occur (e.g., sharp corners, tie-off points).

Under no circumstances can electronic monitoring (e.g., cameras) be used as the primary observation method of the inmate placed on suicide watch. All monitoring of the inmate on suicide watch must be done through constant direct visual observation.

Inmates on suicide watch will be placed in one of the institution’s designated suicide watch rooms, a non-restrictive housing unit room, ordinarily located in the Health Services area. Placement of a suicide watch room in a different area may be warranted given the unique features of some institutions. However, administrative detention and disciplinary segregation cells will not be designated or used as suicide watch cells. Designating a suicide watch room outside the Health Services area requires the Warden submit a policy waiver request through the Regional Director (RD) to the Assistant Director (AD) with oversight of the PSB. If the policy waiver request is approved, the policy waiver must be renewed annually. A list of sites with current waivers is maintained by each Regional Psychology Services Administrator.

Under emergency conditions, an inmate deemed appropriate for suicide watch placement may be placed temporarily on suicide watch in a cell other than the institution’s designated suicide watch room (e.g., R&D cell), as long as all other conditions of suicide watch are met, as described below. As soon as an officially designated suicide watch room becomes available, the inmate must be relocated to that room.

As early as possible in the course of a suicide watch, psychologists will begin meeting with the inmate face-to-face (e.g., in the suicide watch cell, in a nearby treatment room, in an outdoor recreation area). Additionally, Therapeutic Release can be considered based on the needs of the inmate. Information on Therapeutic Release can be found on the PSB page of the Bureau’s intranet site.

(2) Conditions of Confinement. While on suicide watch, an inmate’s conditions of

5332.01 3/19/2026 Federal Regulations from 28 CFR: this type. Implementing instructions: this type. 16

confinement will be the least restrictive necessary to ensure control and safety. The inmate will be seen in-person by a psychologist at least once per day, including weekends and holidays. The psychologist will interview and interact with the inmate and complete clinical notes following each visit in the EHR. Ordinarily, the notes will be completed immediately following the contact and before the psychologist departs the facility.

Because suicide watch imposes significant limitations on an inmate’s independence, much like restrictive housing, Correctional Services supervisors or designees, Institution Duty Officers (IDOs) and medical providers will also have daily contact with inmates on suicide watch and be responsive to needs that may arise. The Executive Staff, Chaplains, Education, Unit Management, and Recreation staff, as well as staff from other disciplines who are responsible for meeting the needs of the inmate on suicide watch, make initial contact within 48-hours and provide follow-up as needed, but at a minimum once weekly following the initial contact. All staff making contact with the inmate on watch must document their interaction in the suicide watch observation log.

Suicide watch-specific items (i.e., safety smocks, blankets, sleeping bags, mattresses, and booties), when authorized by Psychology Services, should be procured from PSB approved vendors. Approved vendors for these items can be found on the PSB page of the Bureau’s intranet site.

A psychologist determines the type of personal property, bedding, clothing, and other items (e.g., reading materials) that may be allowed inside the suicide watch room, and this decision may not be modified by anyone other than a psychologist. At a minimum, an individual should always be authorized undergarments while on suicide watch unless there is a clear clinical indication they are at imminent risk to use that item to engage in SDV. If clinical rationale indicates such, this should be clearly documented in the SRA or daily Suicide Watch Contact.

As outlined in the Program Statement Special Housing Units, alternate clothing/linen (paper or plastic) is not authorized for inmates on suicide watch. Alternative meals and utensils must be approved by the Warden as outlined in the Program Statement Food Service Manual. It is recommended the psychologist complete and sign a BP-A1183, Suicide Watch Property Authorization form and post it in a prominent location in the suicide watch area where it does not hinder the visibility of the inmate on watch and is easily accessible to the observer conducting the suicide watch (e.g., placed on the door). This is to ensure all staff are aware of authorized items and/or changes. Upon placement on suicide watch, the psychologist is to be consulted to determine if the individual on observation can engage in legal and special social visits safely and notate this recommendation on the form. Types of special social visits are outlined in Program Statement Visiting Regulations. As suicide watch progresses, it is recommended the psychologist either initial and date the approved authorization form or provide an updated BP-A1183, Suicide Watch Property Authorization form.

5332.01 3/19/2026 Federal Regulations from 28 CFR: this type. Implementing instructions: this type. 17

Psychology Services provides timely notification to the Executive Staff, department heads, Lieutenants, and the inmate’s Unit Management staff when a suicide watch is initiated and terminated. Correctional Services, in consultation with Psychology Services, are responsible for the inmate’s daily custodial care, cell, and routine activities (e.g., showering, use of bathroom, cleaning, changing clothes). At a minimum the personal hygiene and showering of individuals placed on suicide watch should be managed in accordance with Program Statement Special Housing Units; however, at times additional showers may be necessary while on suicide watch due to the unpredictable nature of suicide watch. It is recommended that the individual on suicide watch be offered an opportunity to shower within 24 hours of their placement on observation, regardless of the day of the week.

(3) § 552.42 Suicide watch conditions. (b) Observation. (1) Staff or trained inmate observers operating in scheduled shifts are responsible for keeping the inmate under constant observation. (c) Psychological Observation log. Observers are to document significant observed behavior in a log book. Standards of Observation. For all observers of inmates on suicide watch:

• Inmates on suicide watch require constant visual, in-person observation. At no time should video monitoring of any type be used as the primary method of monitoring an inmate on suicide watch.
• Any visual observation techniques used to monitor the observers will focus solely on the observer and will not be used as a substitute for constant visual, in-person observation of the inmate on suicide watch. The use of video observation for observers does not replace the need for physical hourly rounds to be conducted to check on the Suicide Watch Companions.
• The observer must have a means to summon help immediately (e.g., phone, two-way radio) if the inmate on suicide watch displays any self-injurious or dangerous behaviors.
• At non-MRC sites, observers may only monitor one inmate on suicide watch. A separate observer must be assigned to each inmate on suicide watch. Ordinarily, staff observers and Suicide Watch Companions will not work side-by-side in this capacity.
• At MRCs, observers may watch no more than two inmates on suicide watch if they can be reasonably and easily maintained in the field of vision without the use of video monitoring.
• When approved by the Warden, legal and special visits require constant observation, and use of a logbook by a staff observer must continue during the visits.

Psychology Services will establish procedures for documenting observations of the inmate’s behavior in a PSB approved suicide watch logbook, see PSB intranet page for ordering information. Entries will ordinarily be made in at least 15-minute intervals. Logbooks are

5332.01 3/19/2026 Federal Regulations from 28 CFR: this type. Implementing instructions: this type. 18

maintained by Psychology Services as a secure document consistent with guidance in the Records and Information Disposition Schedule. Staff Observers. Staff observers provide direct observation of inmates on suicide watch. Suicide watch post orders must reflect the requirement that suicide watch log entries are documented at least every 15 minutes. Staff assigned to a suicide watch post must review and sign the suicide watch post orders before assuming their post. Psychology Services reviews the suicide watch post orders annually, to ensure their accuracy and that they provide clear direction to staff on documentation requirements.

Staff and Suicide Watch Companions will document in separate approved logbooks. An inmate companion will not document in a staff observer’s logbook.

Staff assigned to a suicide watch post must have received initial training (ICT Phase I) and AT thereafter. If an individual has completed ICT Phase I and has not yet made it to AT, they may work a suicide watch post.

(4) § 552.42 Suicide watch conditions.

(b) Observation. (2) Only the Warden may authorize the use of inmate observers. Suicide Watch Companions. Each Warden will determine whether there is a formal Suicide Watch Companion Program in conjunction with the approval of PSB. The recommendation to use companions for any specific suicide watch is made on a case-by-case basis by Psychology Services in consultation with Correctional Services. This decision takes into consideration the safety and security needs of the suicidal inmate, Suicide Watch Companions, staff, and the institution as a whole. Only the Warden may authorize the use of Suicide Watch Companions. The Suicide Watch Companion Program is fully described in Section 13 of this program statement. (5) § 552.42 Suicide watch conditions. (d) Termination. Based upon clinical findings, the Program Coordinator or designee will: (1) Remove the inmate from suicide watch when the inmate is no longer at imminent risk for suicide, or (2) Arrange for the inmate’s transfer to a medical referral center or health care facility. Suicide Watch Termination and Post Suicide Watch Report. Based on clinical findings, a psychologist will remove an inmate from suicide watch when they are no longer at elevated acute risk for suicide or exhibiting mental health concerns that warranted their placement on

5332.01 3/19/2026 Federal Regulations from 28 CFR: this type. Implementing instructions: this type. 19

suicide watch. In circumstances in which an inmate’s acute risk for suicide remains elevated or significant mental health symptoms persist over an extended period, they should remain on suicide watch pending exploration of enhanced treatment options. These could include consideration of emergency medication if indicated, application of varied or more intensive evidence-based mental health interventions locally, elevation of the inmate’s mental health care level, and/or transfer to an institution with an advanced care level mission. In some instances, transfer to a Federal Medical Center may be indicated and should be discussed with the PSB and the Bureau’s Chief Psychiatrist.

Institutions will seek guidance from PSB on procedures necessary to effectuate a transfer for inmates in pretrial or holdover status.

Once an inmate has been placed on suicide watch, this status may not be terminated under any circumstances without a psychologist performing a face-to-face, in-person evaluation. Only a psychologist has the authority to remove an inmate from suicide watch.

If it is determined that an interruption in suicide watch is necessary (i.e., outside hospital trip, transfer to another agency, mandatory release from custody, or transfer to another institution) a Post Suicide Watch Report must be completed indicating there were administrative reasons for the termination of suicide watch. When the individual returns to the institution they will be reassessed for suicide risk via SRA.

To ensure continuity of care, the Post Suicide Watch Report will ordinarily be completed in the EHR prior to the physical termination of the suicide watch, or as soon as possible following termination. At a minimum, the Post Suicide Watch Report must include:

• Suicide watch start and end dates and times.
• Indication of whether staff and/or Suicide Watch Companions conducted the watch.
• Current mental status.
• Narrative for risk factors reassessed (briefly restate the risk factors that were identified in the SRA).
• Changes in risk factors assessed (provide an explanation of which risk factors have stabilized during the course of the suicide watch and which protective factors have increased, if any).
• Reason for removal from observation (a brief, integrative narrative rationale as to why suicide watch is no longer necessary).
• Diagnosis.
• Conclusions (overall acute and chronic suicide risk).
• Recommendations (will offer social, environmental, and mental health interventions as well as conditions of confinement. When mental health interventions are deemed unwarranted, the psychologist must provide a strong and clearly articulated rationale for this decision based on a comprehensive conceptualization of the inmate’s needs).

5332.01 3/19/2026 Federal Regulations from 28 CFR: this type. Implementing instructions: this type. 20

• If Psychology Services recommends an inmate’s transfer to a medical referral center or health care facility, it will be done in collaboration with all departments involved in requesting/pursuing the transfer.

b. Additional Environmental Interventions. Other environmental interventions, such as

involvement of mental health companions, connection with Prison Visitation and Support (PVS), legal and/or special social visits, housing changes (e.g., double celling, property restrictions, cell placement), heightened staff or inmate interaction, or greater observation may be appropriate based on assessed level of risk. While the Warden or their designee has the final decision-making authority on approval of visitations, it is recommended a psychologist and the Captain are consulted when considering legal and/or special social visits for inmates on suicide watch. Each institution will address local procedures for conducting legal and special social visits in accordance with the Program Statement Visiting Regulations.

As outlined in the Program Statement Use of Force, Application of Restraints, and Firearms, placement in restraints to address instances of SDV is a decision that must be recommended by Correctional Services and approved by the Warden.

11. MENTAL HEALTH INTERVENTIONS

Mental health interventions for inmates at risk for SDV and/or suicide must be planned and offered in direct response to an inmate’s specific identified dynamic risk factors for both acute and chronic suicide risk. For inmates who report or demonstrate a reluctance or unwillingness to participate in mental health interventions, the treatment provider should emphasize relational techniques (e.g., rapport building, motivational interviewing, social interaction, modeling) during clinical contacts. Lack of desire for or refusal to participate in treatment is not a rationale for withholding care. If mental health interventions are clinically indicated, they should be planned and scheduled by the psychologist. Inmates’ requests for services should not be a requirement for obtaining clinically indicated mental health treatment.

a. During Suicide Watch. For inmates placed on suicide watch, evidence-based mental health

interventions should be initiated during observation and documented in daily Suicide Watch Contact notes in the EHR. Interventions at this stage should focus primarily on addressing acute dynamic risk factors for suicide and symptom mitigation for uncontrolled mental health symptoms. These interventions should strive to stabilize mental health concerns and dynamic risk factors for SDV or suicide to such a degree that suicide watch can be safely terminated.

Interventions entered into the EHR may include, but are not limited to:

• Collaborative establishment of a Safety Plan.
• Completion of a reasons for living card.
• Coping cards.

5332.01 3/19/2026 Federal Regulations from 28 CFR: this type. Implementing instructions: this type. 21

• Cognitive behavioral therapy (CBT) and Dialectical Behavioral Therapy (DBT) skills training.
• Brief cognitive behavioral therapy for depression or suicide.
• Emotional self-regulation.
• Restructuring of criminal thinking.
• Therapeutic Release, as described on the PSB page of the Bureau’s intranet site.
• Other evidence-based practices deemed applicable to the inmate’s unique treatment needs.

b. Post Suicide Watch Follow-Up. Once suicide watch can safely be terminated, additional

clinical follow-up plans should address maintaining the stability of the mental health concerns and dynamic risk factors that contributed to the placement on suicide watch. Interventions may be delivered individually or via therapeutic groups, that address treatment needs outlined in the Post Suicide Watch Report or treatment plan, and are provided at a frequency commensurate with the inmate’s mental health care level and treatment needs. For more information about mental health treatment, see Program Statement, Treatment and Care of Inmates with Mental Illness. It is recommended all inmates being removed from suicide watch have follow up interventions indicated.

c. Inmates Not Placed on Suicide Watch. Sometimes when inmates are assessed for suicide

risk or uncontrolled mental health concerns, acute risk is assessed as low or it is the clinical opinion of the psychologist that suicide watch is not the least restrictive means to manage the inmate, a suicide watch is not initiated. These circumstances do not necessarily convey that mental health interventions are not warranted. If uncontrolled mental health concerns and/or dynamic risk factors for suicide were identified in the assessment, particularly if chronic risk for suicide was identified, these should be addressed by offering mental health interventions matched to those treatment needs. Interventions are particularly important under these circumstances in order to mitigate risks associated with the decision not to initiate suicide watch. Following the SRA, it is strongly recommended follow-up intervention and procedures be documented and adhered to. Deviation from the recommended follow-up interventions should also be documented.

d. Inmates with Antisocial Personality Disorder. Inmates with Antisocial Personality

Disorder often present with agitation, impulsivity, and/or suicidal statements or behaviors that may be motivated by a desire to change their circumstances. Inmates with this constellation of behavioral symptoms are at increased risk for death by suicide. Therefore, it is essential Antisocial Personality Disorder be recognized as a mental disorder, that mental health care levels be assigned commensurate with the inmate’s level of need for services, and mental health interventions are offered to match those needs. Establishing rapport, conveying empathy, maintaining boundaries, restructuring criminal thinking errors, reducing anxiety, treating substance use disorders, and engaging the inmate in problem solving are useful strategies for this population. Clinical services that address mood and/or substance use are often the most

5332.01 3/19/2026 Federal Regulations from 28 CFR: this type. Implementing instructions: this type. 22

appropriate and should be incorporated into an inmate’s treatment plan.

12. REPETITIVE SELF-DIRECTED VIOLENCE AND SUICIDE ATTEMPTS

Some inmates are at high risk for SDV, but do not easily engage in treatment. These inmates threaten or engage in repetitive SDV for diverse reasons. Psychologists identify the underlying adaptive reasons for threatened or actual SDV and target these using individualized treatment interventions that increase appropriate, safe behavior and reduce risk of serious injury or death by suicide.

a. Functional Behavioral Assessment (FBA) to Reduce Repetitive SDV. An FBA is one tool

used to identify adaptive psychological, biological, social, and/or environmental function of outwardly destructive and disruptive threats and behavior.

The FBA is never used in place of an SRA. An FBA may be warranted after an inmate displays a documented pattern of maladaptive behaviors and/or ineffective coping skills resulting in the need for multiple SRAs.

An FBA is completed by gathering data to identify patterns of repeated threats and acts of SDV. Data gathered from an FBA is then used to formulate a concise statement explaining the purpose of a behavior. This conceptualization informs the treatment plan, is discussed in Care Coordination and Reentry (CCARE) Team meetings, and guides evidence-based treatment interventions. An FBA will always result in an individualized treatment plan.

An FBA must include:

• A clear description of the target behavior as understood through data gathering (e.g., clinical interviews, behavioral observations, record reviews, staff observations).
• An analysis of the environmental, social, and intrapersonal factors that drive and perpetuate SDV (e.g., establishing relationships between antecedents, behaviors, and consequences).
• An explanation of what individually meaningful reinforcers (e.g., social interaction with staff, praise for appropriate behaviors, increased privileges such as phone calls, visits, or recreation time) will be recommended and how they will be applied to increase healthy/adaptive behavior.
• A review of past interventions and exploration to known barriers to learning or implementing interventions.

Guidance on conducting and using FBAs effectively is available on the PSB page of the Bureau’s intranet site as well as by contacting the PSB.

b. Treatment Plans for Inmates with Repetitive SDV. Inmates who engage in repetitive SDV

5332.01 3/19/2026 Federal Regulations from 28 CFR: this type. Implementing instructions: this type. 23

must have this problem listed on their treatment plan with associated goals and interventions. Specific Problem-Goal-Interventions (PGIs) related to suicide risk reduction are located in the EHR and are an integral part of the inmate’s comprehensive treatment plan.

These treatment plans are built around positive reinforcement/rewards because positive reinforcers increase future likelihood of a behavior. Negative reinforcers/punishments are not to be used. The only appropriate limitations to an inmate’s property and privileges recommended by Psychology Services staff are those deemed clinically necessary to restrict access to means for self-harm (e.g., razor restriction, safety garments and linens, alternative meals, pill line only medications).

13. SUICIDE WATCH COMPANION PROGRAM

Suicide Watch Companion teams are established and maintained at the discretion of the Warden in conjunction with the approval of PSB. Psychology Services is responsible for the selection, training, assignment, and removal of individual Suicide Watch Companions.

a. Selection of Suicide Watch Companions. Due to the very sensitive nature of such

assignments, the selection of Suicide Watch Companions requires considerable care. To provide round-the-clock observation of potentially suicidal peers, a sufficient number of Suicide Watch Companions should be trained, and alternate candidates should be readily available. Suicide Watch Companions are selected based upon their ability to perform the specific tasks necessary with intermittent staff supervision, and for their reputation within the institution. In the judgment of Psychology Services, the inmate must be considered credible and reliable by both staff and inmates (e.g., Unit Management, Special Investigative Services [SIS]). They must protect the privacy of inmates placed on suicide watch from other inmates and be accepted in the companion role by staff.

Inmates who have been found to have committed a 100-level prohibited act within the last three years may not be selected as Suicide Watch Companions. Ordinarily, Suicide Watch Companions will be designated Bureau inmates. At facilities housing primarily pretrial inmates, without sufficient designated work cadre inmates to fulfill the role of Suicide Watch Companions, pretrial inmates may be used as Suicide Watch Companions with the written approval of the Warden.

b. § 552.42 Suicide watch conditions.

(b) Observation.

(3) Inmate observers are considered to be on an institution work assignment when they are on their scheduled shift.

5332.01 3/19/2026 Federal Regulations from 28 CFR: this type. Implementing instructions: this type. 24

Suicide Watch Companion Pay. Suicide Watch Companions will be paid. They are considered to be on an institution work assignment while attending training or observing an inmate on suicide watch. This work assignment must take precedence over any other work detail assignment; pay should be at a level to attract and maintain highly qualified Suicide Watch Companions. Companions are paid based on the hourly pay rate for their assigned work grade.

The Suicide Watch Companion program is a First Step Act (FSA) approved program and as such, inmates participating in this program are eligible to receive incentives and benefits in accordance with FSA policy. Suicide Watch Companions can not be paid for their services using FSA funds.

c. § 552.42 Suicide watch conditions.

(b) Observation. (1) Staff or trained inmate observers operating in scheduled shifts are responsible for keeping the inmate under constant observation. Suicide Watch Companion Shifts. A Suicide Watch Companion’s schedule may never include more than one four-hour shift during any 24-hour period. While Suicide Watch Companions should not be regularly scheduled for more than four hours in a 24-hour period, under exigent circumstances they may work up to five hours. A Suicide Watch Companion can never work more than five hours in a 24-hour period.

d. Suicide Watch Companion Training.

(1) Frequency, Duration, and Documentation of Training. At a minimum, one three-hour training is required for all Suicide Watch Companions each quarter. Attendance for the full duration of quarterly training sessions is mandatory. Training may be divided into two sessions per quarter if necessary.

Quarterly training will occur at least once during each of the following four quarters:

• Quarter One: January 1 to March 31
• Quarter Two: April 1 to June 30
• Quarter Three: July 1 to September 30
• Quarter Four: October 1 to December 31

Quarterly trainings must occur at least 30 days apart. Additional trainings/meetings may be scheduled as needed and at the discretion of the SPPC. Newly selected Suicide Watch Companions must attend one complete quarterly training (three hours) prior to working a suicide watch.

5332.01 3/19/2026 Federal Regulations from 28 CFR: this type. Implementing instructions: this type. 25

Participation on the Suicide Watch Companion team will be documented as follows:

• An Agreement of Understanding, signed by each companion (scanned and attached to the companion’s EHR record using document manager).
• The date and duration of each training session, topics discussed, and inmate attendance, documented in the EHR (e.g., open group).
• A schedule or list of Suicide Watch Companions available to Correctional Services personnel during non-regular working hours.
• Verification of Suicide Watch Companion pay and benefits.

(2) Training Topics. Each quarterly training will include basic elements of suicide watch and one or more quarterly topics selected from the current training guide, as described on the PSB page of the Bureau’s intranet site. Additional content may be added at the discretion of the SPPC, such as debriefing suicide watches that occurred during the preceding quarter. If a particular suicide watch was potentially stressful or upsetting (as reported by the inmate companion) to Suicide Watch Companions or role conflicts are known to have occurred between staff and companions, the SPPC must schedule a debrief for companions who have been affected, ideally within two working days, but not to exceed five working days, of the end of the suicide watch.

e. Supervision of Suicide Watch Companions. All suicide watches and Suicide Watch

Companions require staff supervision.

Supervision of Suicide Watch Companions will be provided by staff who are in the immediate area of the suicide watch room or who have continuous video observation of the Suicide Watch Companion and inmate on suicide watch.

In all cases, when a Suicide Watch Companion alerts staff to an emergency by calling control or notifying staff in the area, staff must immediately respond immediately to the suicide watch room and take necessary action to prevent the inmate on suicide watch from incurring debilitating injury or death. The expected response time for staff to get to the suicide watch area is within three minutes.

At no time will a Suicide Watch Companion be assigned to a suicide watch without adequate provisions for staff supervision or without the ability to obtain immediate staff assistance (i.e., a phone that calls directly to control). The decision to use Suicide Watch Companions must be predicated on the fact that it takes only three to four minutes for most deaths by suicide to occur.

Supervision of Suicide Watch Companions must consist of at least 60-minute checks conducted in person. Staff must sign the chronological suicide watch logbook in use upon conducting checks.

5332.01 3/19/2026 Federal Regulations from 28 CFR: this type. Implementing instructions: this type. 26

Suicide Watch Companions may not be used in any situation involving an inmate on hunger strike or in restraints.

f. Removal. Psychology Services staff may remove any Suicide Watch Companion from the

program at their discretion. Removal of a Suicide Watch Companion should be documented in the EHR.

14. TRANSFER OF INMATES TO OTHER INSTITUTIONS

§ 552.42 Suicide watch conditions.

(d) Termination. Based upon clinical findings, the Program Coordinator or designee will:

(2) Arrange for the inmate’s transfer to a medical referral center or health care facility.

Psychology Services staff are responsible for making emergency referrals of suicidal inmates to a Federal Medical Center. No inmate who is acutely suicidal will be transferred to a Bureau facility other than a Federal Medical Center on an emergency basis without the recommendation of the Regional Psychology Services Administrator and PSB. Inmates who are chronically but not acutely suicidal may be considered for an advanced care level referral. If pretrial inmates are in need of transfer, consultation should be sought from the Regional Psychology Services Administrator and PSB.

Inmates on prolonged suicide watches should be considered for transfer, as should inmates whose mental health treatment needs overwhelm the mission or resources of the current institution. When an inmate has been on suicide watch for 72 hours and may require a medical center or advance care level referral, a psychologist will contact the Regional Psychology Services Administrator who will consult with the NSPC to discuss the case and determine if a transfer is appropriate. As part of the referral consideration process, it is often beneficial to consult with other mental health resources such as the treating psychiatrist, psychologists at other institutions, Regional Psychology Services Administrators, PSB subject matter experts, or the Bureau Chief Psychiatrist.

The psychologist will document consultations and referral considerations, and all actions taken, in the inmate’s EHR record. If the decision is not to transfer the inmate, the consultation and rationale for the decision must be documented in the EHR, along with specific plans for continuing to address the inmate’s treatment needs locally.

a. Federal Medical Center Referrals. Inmates who do not respond to treatment interventions

(e.g., evidence-based psychosocial interventions, voluntary medication, or emergency medication) and remain acutely suicidal may require emergency hospitalization. Although a Federal Medical Center referral may be indicated at any time, inmates will ordinarily be referred

5332.01 3/19/2026 Federal Regulations from 28 CFR: this type. Implementing instructions: this type. 27

when they have been determined to be psychiatrically complex, are in an acute state of distress, or the Chief Psychiatrist recommends transfer.

b. Advanced Care Level Referrals. Inmates who engage in SDV or consistently report

suicidal ideation may not require suicide watch or require inpatient care. These inmates should be engaged in evidence-based mental health interventions (e.g., Brief Cognitive Behavioral Therapy for Suicide [B-CBT], Dialectical Behavior Therapy [DBT], and Emotional Self-Regulation [ESR]) locally. When treatment progress indicates more intensive services are needed, as evidenced in the EHR documentation (e.g., Diagnostic and Care Level Formulation [DCLF], clinical contacts), consultation will be sought from PSB staff regarding a referral to an institution with a higher mental health care level.

c. Communication. It is critically important that other institutions are notified when they are to receive inmates with recent suicidal ideation and/or who are at risk for SDV. A psychologist from the sending institution must ensure that a suicidal or self-injurious inmate being transferred to or from a Federal Medical Center or advanced care level facility has the following documentation:

• A Psychology Alert code in the applicable Bureau inmate management system.
• Clinical documentation supportive of continuity of care (e.g., a completed Mental Health Treatment Summary).
• All pending notes finalized in the EHR prior to transfer so they are immediately visible to the receiving institution.
• Added to the PAL.

Refer to PSB’s page on the Bureau’s intranet site for guidance regarding the appropriate codes in the applicable Bureau inmate management system. These steps ensure staff are informed of serious psychological management problems and continuity of care issues in a timely fashion. In many instances, a phone call to the Chief Psychologist, Advanced Care Level Psychologist, or appropriate Psychology Treatment Program Coordinator at the receiving institution will greatly aid the inmate’s adjustment during the transition period.

15. SELF-DIRECTED VIOLENCE HIGH LETHALITY REVIEW

In the event of a serious suicide attempt at an institution (e.g., an attempt that could have reasonably resulted in death and is categorized as “high lethality” by the assessing psychologist on the SRA), the BP-A1182, Self-Directed Violence High Lethality Review form is utilized to conduct a local review of the incident. This is a multidisciplinary review process conducted under the direction of an Associate Warden and involving collaboration and input from the Captain, HSA, Unit Manager, Chief Psychologist, and any other department head with relevant information to contribute to the review. The goal of the review is to identify lessons learned and enhance future suicide prevention efforts at the local level. The completed Self-Directed

5332.01 3/19/2026 Federal Regulations from 28 CFR: this type. Implementing instructions: this type. 28

Violence High Lethality Reviews are forwarded to the respective RD, Regional Psychology Administrator, and PSB on at least a quarterly basis. Locally, completed Self-Directed Violence High Lethality Reviews are digitally stored by the institution Psychology Services department.

16. PROCEDURES FOLLOWING AN INMATE SUICIDE

In the event of an obvious or suspected (e.g., potential overdose) inmate death by suicide, the Warden will make appropriate notifications to the RD and Central Office Executive Staff. The Chief Psychologist will notify the NSPC and the Regional Psychology Administrator.

The need to perform life-saving measures takes top priority and should not be delayed or curtailed based on a presumption of death (except in those circumstances outlined in Program Statement Patient Care) or concerns about crime scene preservation.

In accordance with Program Statement Crime Scene Management and Evidence Control, following the emergency response, the suicide scene will be treated in a manner consistent with an inmate death investigation. All measures to preserve and document the evidence needed to support subsequent inquiries will be undertaken and recorded. Institution staff, particularly the Evidence Recovery Team, will handle the site with the same level of protection as any potential crime scene in which a death has occurred. When there is an inmate death or serious incident that may lead to death or incapacitation, the incident will be recorded in TRUSCOPE. Once all evidence and property have been secured, examined, retained, and written Federal Bureau of Investigation (FBI) declination has been obtained (if applicable), the scene may be released.

In the event of an inmate death by suicide, no clinical documentation from Psychology Services should be added, altered, or completed after the death.

a. Psychological Reconstruction of an Inmate Suicide. The professional purpose of a

Psychological Reconstruction is to aid in the understanding and prevention of suicide. The specific goals of each Psychological Reconstruction are to determine, if possible, why an inmate decided to end their own life, and what can be learned from the death that could help to strengthen the institution’s local suicide prevention program and the Bureau’s national suicide prevention program. Psychological Reconstruction reports do not focus solely on policy violations but also on the identification and recommendation of new practices that strengthen the Bureau’s suicide prevention program.

Ordinarily, the RSD AD, will authorize a Psychological Reconstruction of an inmate suicide to be completed under the direction of the NSPC or another psychologist from the PSB. Central Office psychologists who have previously been involved in treating or consulting about the inmate ordinarily do not participate in the reconstruction. A Psychological Reconstruction team may consist of additional staff including, but not limited to, representatives from the Office of General Counsel (OGC), the Health Services Division (HSD), the Correctional Programs

5332.01 3/19/2026 Federal Regulations from 28 CFR: this type. Implementing instructions: this type. 29

Division (CPD), and regional staff as approved by the RD. Participants from the field may be considered on a case-by-case basis but must be at the department head level or above. If a death by suicide occurs at an RRC, a suicide reconstruction may be conducted depending on the specific concerns of the agency.

Wellness of staff and inmates following a death by suicide is of the utmost importance. One task of the reconstruction team is to ensure wellness of both groups is addressed during the site visit.

At the conclusion of the reconstruction, a report is prepared that addresses all of the areas outlined in the Guide for the Psychological Reconstruction of an Inmate Suicide. This guide can be found on the PSB page of the Bureau’s intranet site. The report will be reviewed by OGC, HSD, and CPD; feedback will be considered by the NSPC and/or the psychologist who authored the report. Other disciplines may be consulted at the discretion of the NSPC based on the unique features of a particular case.

The RSD AD will review and approve the final report and disseminate copies to the Health Services Division AD; the Correctional Programs Division AD; the Program Review Division AD; the RD responsible for the institution where the suicide occurred; the Warden at the institution where the suicide occurred; and other Wardens as appropriate (e.g., if the inmate was recently transferred). The final report will ordinarily be routed within 120 days of the completion of the site visit.

If the suicide occurred at an RRC, and a reconstruction is conducted, the report is disseminated to the RRMB Administrator.

b. Psychological Reconstruction Follow-Up Procedures. Within 60 days of receiving a

Psychological Reconstruction report, the Warden prepares an Institution Response. Wardens are encouraged to consult with the Regional Psychology Administrator in preparing the institution’s response. The response will include a comprehensive corrective action plan and is routed by the Warden through the RD to the RSD AD. A copy of the memo format for this corrective action plan can be found on the PSB page of the Bureau’s intranet site.

If the suicide occurred at an RRC, and reconstruction is conducted, the RRM overseeing that RRC completes the follow-up procedures outlined in this Section of the program statement.

Upon receipt by the RSD AD, the Institution Response will be forwarded to the NSPC and/or the author of the Psychological Reconstruction report for review. If all corrective action plans appear to be appropriate, the RSD AD prepares a response for the Warden through the RD indicating the conclusion of the psychological reconstruction process. If there are questions or concerns about the corrective action plan, a detailed response is prepared and routed from the RSD AD through the RD to the Warden requesting additional information or clarification. Should that occur, a follow-up Institution Response is submitted to the RSD AD within 30 days.

5332.01 3/19/2026 Federal Regulations from 28 CFR: this type. Implementing instructions: this type. 30

c. Reporting Frequent Psychological Reconstruction Findings. The NSPC will track trends

in deaths by suicide, frequent recommendations, and best practices to prevent suicide. This information will be compiled into a report and distributed broadly (e.g., ADs, RDs, Wardens, Psychology Services staff) on a quarterly basis.

d. Risk Reduction Reviews. Institutions identified as having high rates of inmate death by

suicide will receive a Risk Reduction Review from a multidisciplinary team approved by the RSD Assistant Director. At a minimum, this team will include two representatives from PSB, a representative from HSD, a representative from the Correctional Services Branch, and representatives from the regional office (as approved by the RD). Risk Reduction Reviews will occur at institutions that experience two or more inmate deaths by suicide in two calendar years. This also applies to complexes. Ordinarily, at a complex, each institution will be treated as an individual entity for the purposes of a Risk Reduction Review. If a complex has two or more deaths, and the deaths occurred at separate institutions, no Risk Reduction Review will be completed. If there are two or more deaths at a single institution within the complex, a Risk Reduction Review will be completed. Other circumstances may warrant a review outside of these criteria at the discretion of the RSD AD. The review will examine adherence to reconstruction recommendations, physical safety, communication and interaction styles, provision and fidelity of evidence based mental health treatment, perceptions of the use of discipline and restrictive housing, the reporting and referring culture of the facility (e.g., is it caring), and facility staffing. A report will be written to disseminate findings and make additional recommendations.

5332.01 3/19/2026 Federal Regulations from 28 CFR: this type. Implementing instructions: this type. 31

REFERENCES

Program Statements Food Service Manual Female Offender Manual Management of Inmates with Disabilities Visiting Regulations Special Housing Units Intake Screening Treatment and Care of Inmates with Mental Illness Psychology Services Manual Crime Scene Management and Evidence Control Use of Force, Application of Restraints, and Firearms Patient Care Psychiatric Services

Bureau Forms Prescribed by 5332.01 BP-A1182, Self-Directed Violence High Lethality Review BP-A1183, Suicide Watch Property Authorization

Other Bureau Forms BP-A0519, Psychology Services Inmate Questionnaire

Federal Regulations 28 CFR 552.40–42.

ACA Standards Performance-Based Standards and Expected Practices for Adult Correctional Institutions (5th Edition): 5-ACI-1D-12, 5-ACI-1D-13, 5-ACI-4B-28(M), 5-ACI-6A-31(M), 5-ACI-6A-32(M), 5-

ACI-6A-35(M), 5-ACI-6B-08(M), 5-ACI-6B-12, 5-ACI-6B-13, 5-ACI-6D-02(M)

Performance-Based Standards and Expected Practices for Adult Local Detention Facilities (5th Edition): 5-ALDF-2A-20, 5-ALDF-2B-04, 5-ALDF-4C-28(M), 5-ALDF-4C-29(M), 5-ALDF- 4C-31(M), 5-ALDF-4D-08(M), 5-ALDF-4D-11, 5-ALDF-4D-31(M), 5-ALDF-7B-08, 5-ALDF- 7B-10, 5-ALDF-7B-11

Records Retention Requirements Requirements and retention guidance for records and information applicable to this program are available in the Records and Information Disposition Schedule (RIDS) on the Bureau’s intranet site.

Reviewed for legal accuracy by Elizabeth Franklin-Best, Esq., Principal Attorney·September 2026