Rachel Jacobs

Writer’s comment: Throughout the long ordeal of seeking treatment for my mentally ill daughter, I have actively pursued every possible way to advocate for Amber in her struggle to recover her mental health. Amber is one of the faceless, voiceless children that are shuffled through the Juvenile Court System in search of appropriate treatment. Amber’s story is typical of what happens to mentally ill children, who, because of their resistance to treatment and a tendency to run away, require locked mental health facilities. Although the voice in this article is mine, Amber gave me permission to tell her story, in the hope that her experience will show how urgently we need to provide appropriate care for our mentally ill children.
        I wish to thank Jayne Walker for her encouragement and her belief that this article deserves an audience, and for her tireless editorial efforts in my behalf.
—Rachel Jacobs

Instructor’s comment: In “Amber’s Case,” Rachel Jacobs’ first-person reporting transforms painful experience into powerful advocacy. She tells the story of her daughter’s mental illness lucidly and unsentimentally, weaving in contextual details that make the reader see both how and why Amber has been so poorly served by a “system designed to fail her.”
        Another of Rachel’s pieces, “The Invisible Parent,” scored equally high in the Prized Writing competition. She decided, and I agreed, that this is the one that should be published. The issues that “Amber’s Case” illuminates have gone virtually unreported in the press. Because she is committed to publicizing the plight of children like Amber, Rachel enrolled in my feature article writing class and learned how to apply her talent and training in writing fiction to reporting. I’m delighted to think that this Prized Writing clip will help open doors for her as a free-lance writer.
—Jayne L. Walker, English Department



I have few photographs of Amber from the last four years. Those I do have are marred by shadows of twisted barbed wire and a “Take Pictures Here” sign that looms over her head. In all of them, she is backed up against a red brick wall clad in a prison uniform of royal blue T-shirt or sweatshirt, jeans, and white athletic shoes. Amber is an inmate in the California Youth Authority in Ventura. Her crime is being mentally ill, and she is there because, in the final analysis, there was nowhere else for her to go.
         Four years ago, on a sweltering August afternoon, I committed my thirteen-year-old daughter Amber to Sunridge, an acute care mental health facility in Marysville, California. That day was the beginning of a long, heartbreaking journey to obtain long-term care for my seriously ill child.
         At the time of her initial hospitalization, we were living in a homeless shelter, the consequence of my ex-husband’s refusal to pay child support, and my inability, despite my position as head cook at a local senior care facility, to pay our $650 a month rent in Grass Valley. It was at the shelter that Amber’s long-standing but untreated mental illness began to play havoc with her already tightly circumscribed life. Despite the many horrendous experiences I had endured, including rape, Amber’s hospitalization and subsequent diagnosis were the most difficult challenges I had ever encountered. And they were only the beginning of my ongoing struggle to obtain proper treatment for her in a system that is designed to fail her.
         That summer Amber’s behavior was wildly out of control, swinging from extreme agitation and hyperactivity to lethargy and suicidal depression. She was diagnosed as suffering from bipolar disorder, better known as manic-depressive illness, and borderline personality disorder. While some of her symptoms were caused by the street drugs she sought in an effort to self-medicate, some of them typified my daughter’s temperament from birth.
         For years I had told friends that something was wrong with Amber. Amber was a difficult baby and an impossible toddler. She was different from other children and seemed always to be struggling to keep herself under rigid control. When she lost control, she raged for hours on end. One afternoon, when she was four, she ran around her bedroom in circles screaming at the top of her lungs for nearly two hours. I never knew what to do when these tantrums occurred. She was beyond soothing, or punishment, or threats, locked into some outrageous cycle of activity promoted by an unseen attacker. But when she was in control, she could be golden—polite, sweet, obliging, and always brilliant.
         As a child growing up during the fifties, I was fascinated and horrified by The Bad Seed, the story of a beautiful girl child who charmed everyone but her mother. While Amber was far from the psychotic child murderer of the film, she exhibited what psychiatrists term “inappropriate emotional response.” Her smiles looked strained and awkward, as if someone had painted them on. She laughed when other children showed fear or alarm. But for the most part, her emotional response was flat.
         Amber rarely slept for more than six or seven hours at a time. By the age of eight, she was staying up half the night reading or cleaning her room. She refused to wear any but the softest clothing, and busied herself with mindless activities like re-arranging her toys over and over. Amber never felt the carefreeness we associate with childhood. She was always burdened with cares.
         I rationalized that her “bad” behavior was caused by colic, or the terrible two’s, or hypersensitivity. The truth was, I was afraid. And when she was golden, I could dismiss my intuition that something was very wrong with her. Until the second semester of the fifth grade, when her world shattered because of her parents’ divorce, Amber was every teacher’s ideal student. Her first grade teacher wrote, “Amber does most things well. Her mature attitude and good study habits result in excellent achievement. She learns quickly, and academically she excels. She is a leader, a help to others, and mostly a positive influence in the classroom.” Amber is also a beautiful child. One psychiatrist described her as “tall, slim, and extremely attractive, with long, lustrous, auburn hair.”
         The social worker and child psychiatrist at Sunridge recommended long-term residential care for Amber. They said that although lithium had brought her bipolar disorder under control by the end of her thirty-day maximum stay, her borderline personality disorder required the discipline of a rigidly structured environment. If she did not receive this kind of treatment, her long-term prognosis was extremely poor. She might easily die of a drug overdose or suicide within a year. Or she could commit a violent act that would result in her incarceration. But when personality disorders presented themselves as early as Amber’s had, her psychiatrist reassured me, there was a good chance that behavior modification therapy could enable her to lead a productive life. Then the psychiatrist threw the final punch. He said that Amber might suffer from “the bad seed syndrome” caused by a genetic brain malformation.
         When I left his office, I almost collapsed in the parking lot. I felt then, and I still feel at times, that my daughter had been given a death sentence. At least, my hopes and dreams for her had died. I’ve learned since that the grieving process is much the same as when a parent loses a child in death. For almost six months, I cried every day. And I blamed myself for her illness.
         Why hadn’t I had her treated before? Why hadn’t I taken her to a psychiatrist when I first suspected she was ill? The reason is that mental illness, and the denial that sometimes accompanies it, runs rampant in my family. Or as Cary Grant quipped in Arsenic and Old Lace, “It doesn’t run, it gallops.” On my father’s side, one child in every generation suffers from it. His grandmother was mentally ill, and his sister was institutionalized repeatedly until she died of alcoholism at the age of forty-seven. Yet when I asked my father her diagnosis, he said he wasn’t sure what it was. My brother made national headlines when he killed his ex-wife’s lover in a manic rage a few years ago. But it was my mother's severe mental illness that colored my assessment of my daughter’s behavior more than any other factor.
         My mother suffers from bipolar disorder and several personality disorders, including histrionic, narcissistic, and borderline. She refuses to admit her illness, despite one hospitalization, and therefore remains untreated. There is an unwritten law in my family that we do not speak of my mother’s mental illness. We were taught to accept her abhorrent and irrational behavior as normal when we were growing up. This learned acceptance of wildly abnormal behavior caused me to distrust my feelings and to blame myself for the irrational actions of others. It is also the reason I married a man who mirrored my mother’s behavior. Amber’s dad was diagnosed with bipolar disorder and borderline disorder after our divorce.
         Because of this history, my daughter’s diagnosis hit me particularly hard. I had seen too many lives, including my own, ravaged by mental illness. Now, I thought, she at least has a chance. I can find her the help that my mother, brother, and ex-husband didn’t receive until much too late. I asked the social worker how I might obtain proper care for Amber. I was informed that MediCal, our only insurance at that time, refused to pay for long-term juvenile residential treatment. Our best hope, she advised, was to involve the juvenile probation department, in the hope that the court would place her in an appropriate facility.
         Amber was already on informal probation for pushing down an ex-boyfriend at school. She had thrown rocks at his house and made harassing phone calls to his home. I was advised to call the probation department whenever she disobeyed one of the many stipulations of her probation. For instance, when she refused to attend school, or left the house without permission, or broke curfew, or associated with undesirable peers, I reported these infractions to her probation officer. Poor behavior that other parents might have handled at home, or possibly dismissed, was handled by the probation department, because I was led to believe that sooner or later the court would place her in an appropriate treatment facility.
         One evening, approximately three weeks after her release from the hospital, Amber informed me that she was going out to meet her friends, all of whom were addicted to crank, and that there was nothing I could do to stop her. She screamed at me relentlessly for almost an hour as I tried to reason with her. Finally, she headed for the door. I moved to block her escape, and she pushed me aside and bolted. Amber had a history of running away. Once, she was gone for two weeks. I phoned the police and asked them to pick her up. Within ten minutes she was back home in the company of two officers. I explained the situation to them and asked them to take her into custody. They said their hands were tied unless I filed an assault charge against her for shoving me. I reluctantly filed the charge and they handcuffed her and took her to Juvenile Hall. This was the beginning of our long, tedious, disappointing journey through the Juvenile Court System.
         Amber spent a month in the Hall, then she was placed on formal probation and rendered a ward of the court. Soon after her release, she was picked up again as a runaway and taken back to the Hall. This time she spent two weeks there before she was released, and the pattern repeated itself. In December of 1993, four months after her diagnosis, she was placed in Our Family, a group home on the grounds of Napa State Hospital.
         According to Ron Sater, a mental health worker in Yolo County, approximately 125,000 emotionally disturbed children in California eventually make their way into the system seeking treatment. Group homes, the most common solution, are numbered according to the restrictiveness of their environment. Children as ill as Amber, who resist treatment and have a history of running away, require locked level-fourteen group homes. What I wasn’t told when I began pursuing treatment for her was that California does not currently have licensed, locked level-fourteens. As a result, four hundred California children are shipped to Utah, Nevada, Arizona, and other states that offer these facilities.
         Our Family was entirely inappropriate for Amber. A popular program for drug-addicted teens, it is staffed by recovering addicts who are not trained to care for the mentally ill. Their policy is that the children are not allowed to leave the grounds, but if they do, they are no longer the legal responsibility of Our Family. Twice they called to inform me that Amber had walked into Napa and that they were looking for her. The second time she walked, Amber spent the night with a family who found her sitting in front of a 7-11 at midnight, being harassed by a group of boys. The next day she was discharged from Our Family and ridiculed by the staff for failing their program.
         Within a month, she stole my checkbook. Her boyfriend forged and cashed $600 worth of bad checks for her and gave her a ride to Reno, where she spent two weeks living with a prostitute. She was found sleeping in a car after trying to drown herself in the Truckee River. The child who only two years before had been selected as student of the year was hauled into the courtroom shackled and handcuffed. She had not taken her medication in over two months and was again completely out of control. Aware of the seriousness of her illness, the judge placed Amber at Kingsview Mental Health Center in Reedly, California. It was now eight months after her diagnosis.