Autumn Matacchiera said she knew something was wrong on that January day, well before she found herself on a train platform in Burlington City. But she couldn’t stop herself.

“I felt myself escalating hours before that,” the 20-year-old said, during one of two calls she made to the Courier-Post from Ancora Psychiatric Hospital during the week after her arrest on Jan. 27.

A thought kept running through her mind. If she offered a sacrifice – like “the golden calf in the Bible,” a book she loved to read – she could win the love of a particular estranged relative. It was her solution to a problem that long plagued her.

She told herself over and over to forget about it. She took some “as needed” anti-anxiety medication and called her counselor.

But it didn’t stop her.

In the days since, many have wondered what could have prevented Matacchiera from picking up a 5-year-old child she didn’t know and throwing the little girl in front of an oncoming train, a horrific incident witnesses called “surreal.” Was she taking her medication as prescribed? Why wasn’t she in a hospital? What was wrong with her?

It turns out, there are no easy answers. There never were.

Joe and Laura Matacchiera of Hainesport adopted Autumn from China when she was 13 months old, completing their family of three. The couple soon realized there was a problem. By age 3, their toddler was diagnosed with reactive attachment disorder, one of the few mental health disorders recognized in infancy.

The disorder is rare and treatable, but can develop when an infant’s basic early needs for love and comfort aren’t met. It’s characterized by a young child’s inability to form a loving relationship with others.

That diagnosis didn’t quite fit. High-functioning and bright, Autumn was later diagnosed with autism spectrum disorder, a developmental disability that affects about 2.5 percent of New Jersey’s children.

By age 13, Autumn required psychiatric hospitalization to treat severe anxiety, the first of many more episodes to come. Eventually, clinicians gave her parents a list of mental illnesses to describe her issues: Autism. Bipolar disorder. Obsessive-compulsive disorder. Anxiety disorder.

“Every day was a struggle,” said Laura Matacchiera, as she sat with her husband and the defense attorney the couple hired to represent Autumn. “We walked on eggshells because of what we said or did.”

Even so, the couple said, she was never a threat to them. Indeed, most people with mental illness are not violent, according to the National Alliance on Mental Illness, and are more likely to be victims of violence.

When people with mental illness act violently, the nonprofit asserts, it’s usually because they didn’t receive appropriate mental health services.

Laura Matacchiera routinely spent hours on the phone, searching for ways to ease her daughter’s fretful mind. When the Matacchieras couldn’t find appropriate treatment in New Jersey, they sent their teenager to out-of-state residential facilities for three to four months at a time, “because that’s where the best services are.”

“We couldn’t find what we needed here,” her mother explained. Over and over, the cycle continued. Autumn would fall into a crisis, get help and recover, only to relapse. Throughout, the Matacchieras maintained hope she would develop into her full potential. Even now, Laura Matacchiera calls her “a great kid.”

“She’s our child,” Matacchiera explained. “We’ve never once given up … because everybody deserves the best chance they can get.”

After seven years in the mental health system, Autumn Matacchiera was intimately familiar with its shortcomings. She refined a list of recommendations she compiled on how to improve the system before posting them on a blog two weeks before she headed for the train platform. Her suggestions included things like turning off the lights at crisis screening centers so patients could sleep at night, and placing children in areas separate from adults.

A police officer stood on the tracks at this Burlington City station to stop an oncoming train after a woman threw a child on to the tracks last month.
(Photo: Jose F. Moreno/Staff Photographer)

She called her blog, “The Odyssey of The Failing NJ Mental Health and Developmental Disability System.”

“I want to help other people who are in it,” she wrote. “This is not a complaint and is not meant to be investigated.”

According to her blog, she had two meetings scheduled with officials from the state Division of Mental Health and Addiction Services, and the Children’s System of Care, part of the state Department of Children and Families. She also reached out to advocates.

Among them was Donna Icovino, a parent and advocate for people with developmental disabilities and mental illness who helped lead a state task force assigned to study New Jersey’s services for the dually diagnosed population. In 2008, the task force issued recommendations to address the state’s growing need for housing, community services, crisis intervention and hospitalization.

Icovino was struck by Matacchiera’s ability to communicate specific ways to improve the system, a rare quality among people with intellectual or developmental disabilities and mental illness.

“Over the past months, I had the great privilege of supporting Autumn’s advocacy efforts as she prepared to present to the state her recommendations to improve the mental health delivery system,” Icovino said in an email. “She gratefully acknowledged the positive aspects of the system, which had contributed to her own recovery process. However, her journey through the mental health system had also presented great challenge for her, because of existing service gaps and inhumane treatment.

“Autumn wrote ‘The Odyssey’ to bring awareness of these problems to the forefront of the state’s attention, with the hope that necessary reforms would be instituted. More than anything, Autumn wanted to prevent individuals with mental health disorders from experiencing what she recognized as needless human suffering.”

Though there was never a time when she appeared content, her mother said, Autumn was well enough recently to seek out volunteer opportunities. She wanted to work with children with disabilities who suffered like she did. She was receiving mental health services in the community, and preparing to age out of the Children’s System of Care.

She seemed OK.

It’s not known whether Matacchiera was taking her medication as prescribed. That’s a common issue in the mental health world that can lead a person into a crisis, said Lucille Esralew, clinical administrator of CARES (Crisis Assessment Response and Enhanced Services), a state-funded program operated out of Trinitas Regional Medical Center in Elizabeth.

During 2016, the team of clinicians worked with about 1,000 dually diagnosed adults, ages 21 and up, statewide. Matacchiera was not yet old enough to qualify for services from CARES, which works to stabilize developmentally disabled people in crisis for up to 120 days.

Lucille Esralew
(Photo: Provided)

It’s not always apparent that a person is struggling internally.

“If you’re high-functioning on the (autism) spectrum, you probably look a lot more intact than you actually are,” Esralew noted. “That can lead people to believe this individual isn’t particularly in trouble.”

There will be more questions to answer as Matacchiera’s case unfolds. Was she getting the right services? Was she complying with her treatment plan? Did her decisions lead her downward into another crisis?

“Her experience needs to be understood,” Esralew said.

While the mental health system for the developmentally disabled has gaps and access concerns, especially in South Jersey, Matacchiera’s case can’t be held up as an example of its shortcomings, Esralew pointed out. It’s not that simple.

“It’s hard to talk about a system on the basis of the most extreme example,” Esralew said. “You can’t talk about a system with a sample of one.”

Little is known about how people with such complex conditions experience the world, explained Dr. Andrew Levitas, professor of psychiatry and medical director of the RowanSOM Center of Excellence for Mental Health Treatment for Persons with Intellectual Disabilities in Stratford.

According to the National Association for the Dually Diagnosed, people with intellectual and developmental disabilities commonly lived in facilities apart from their families and communities. In 1999, the Supreme Court ruled that institutionalizing people who could live in the community was discriminatory and violated their rights. New Jersey began emptying its developmental centers, shifting to group homes and residential placements instead.

In the meantime, advances in medicine permitted many people with disabilities to live longer lives. Psychiatry has labored to keep pace with such change. And there is little financial incentive for doctors to specialize in treating the dual-diagnosis population.

Dr. Andrew Levitas.
(Photo: Provided)

Few clinicians have the expertise needed to treat such complex patients, Levitas said. Without such background, it’s easy to misread symptoms and prescribe medications that don’t address the real problem, he said.

Besides, he added, autism alone is poorly understood, even less so for girls. Its manifestations vary from individual to individual. If you’ve met one person with autism, it’s often said, you’ve met one person with autism.

“We’re only at the very beginning of understanding,” said Levitas, who has never met Matacchiera and spoke in general about the field. “It’s only been a single generation of mental health professionals who have really been able to come to grips with any of this or who have been able to begin to ask the right questions or think we’re asking the right questions.”

Around 8:30 p.m. on Friday, Jan. 27, a young woman caught the attention of an NJ Transit bus driver. She was wearing a coat over pajamas and “just didn’t seem right,” the driver told police.

Burlington City Police Officer Gregory Pierce called for backup from the other four officers on his shift that night and went to High and Broad streets. As Pierce and Officer Keith Spencer walked up the concrete train platform, they watched a woman grab a small child standing near her mother and throw her about three or four feet down into the path of a River LINE train.

The mother’s boyfriend reached the girl first. Two more officers raced to put themselves between the child and the train, waving and yelling to alert the light-rail train’s driver to brake. The train stopped about 30 feet away from the officers, recalls Sgt. Ron Fuss, who arrived in time to see the scene unfold in front of him.

The child emerged from the incident with a cut on her chin and bruises. No one else was hurt.

Pierce and Spencer arrested Matacchiera without further incident. She was taken to a hospital for a psychiatric evaluation and was later transferred to Ancora, which is in Winslow.

Matacchiera herself still doesn’t appear to grasp the significance of her actions. Asked if she understood that throwing a child in front of an oncoming train was wrong, Matacchiera said calmly that she didn’t know. Asked if she was seeking media attention, she said no. She was looking for the love of her estranged relative.

“I thought it was just a sacrifice,” she said. “I didn’t think it was anything bad. Now, I kind of regret it. … People tell me that sacrificing a human isn’t the same as sacrificing the animal.”

She did have a reason for calling a reporter. Besides speaking out about the treatment she was receiving, she hoped a news story would help her accomplish her next goal.

“I don’t want to be in the community anymore,” Matacchiera said evenly. “I think I should go to jail for the rest of my life.”

The Burlington City police officers who responded that Friday night had experience dealing with people on the autism spectrum. Officer David Edwardson, who stood in the tracks between the child and the train, has a brother with the disorder. Fuss grew up with a boy on the spectrum. Capt. John Fine once worked at a developmental center.

All have received training in how to respond to individuals with disabilities, emotional disturbances and mental illness. The department has maintained a connection with the little girl they helped rescue, but their concern has extended to Matacchiera and her family, too.

“Obviously, we cannot condone any behavior she displayed,” Fine said. “But we didn’t shut the door on her parents. We’ve been in discussions with them as well.”

In the weeks to come, Matacchiera will face a system she’s never encountered before: criminal justice. Brenda Maneri, a former Burlington County prosecutor who is now defending Matacchiera against a charge of attempted murder, was dismayed to learn her client called a media outlet. Because she did, Maneri and the Matacchieras agreed to speak with the Courier-Post about the case.

Matacchiera’s parents said they were shocked by what police told them, and relieved they were there to help save the little girl. Their daughter is ill, they explained. They can’t imagine she acted with malicious intent.

As for the victim’s family, Laura Matacchiera said, “I’m sorry for everything they’re going through now, or in the future.”

“The extent of her mental illness is not to be underestimated or taken lightly,” Maneri said. “We are doing whatever we can as defense attorneys here to make sure she gets the treatment that she needs, and ultimately, when she takes responsibility for this, that the system continues to treat her with the kind of treatment she needs as a mental health patient as opposed to as a criminal.”

After meeting her new client at Ancora, Maneri described the young woman she encountered as lovely, sweet, bright, insightful — and clearly mentally ill.

Even so, the charges are “extremely serious,” Maneri said. “There needs to be a balance here.”

“But it needs to be addressed in the right forum,” Maneri added later, “which is why I’m going to advocate that she not go to state prison.”

The victim’s family declined to comment beyond a statement their lawyer, Casey Colonna, released to the media, thanking police for their actions.

“The physical and emotional trauma that has occurred and will continue to occur is life altering,” the statement read. “The young girl has had some treatment and there will undoubtedly be more to come.”

Colonna is investigating the matter, and may file a civil suit. He would not comment on potential defendants.

What could have been done to prevent something so inexplicable? Even mental health experts are flummoxed.

“First thing is, we have to confront the fact that we don’t know everything there is to know about people with these unusual types of brain organization,” Levitas said. “There are some things our drugs probably won’t reach.”

Some people, the psychiatrist noted, may never be able to live without supervision.

Despite the horrific nature of the incident, the person who committed the act deserves compassion, he said.

“Someone with impaired judgment who commits an act like that – something’s happening in that person’s head that deserves understanding, partly to prevent it from ever happening again, but partly to come to terms with it,” Levitas said.

“She has to go on living with the fact that she did that.”

Kim Mulford: (856) 486-2448; kmulford@gannettnj.com

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