What makes Sammy run?

Huge and helpless, schizophrenic and hypertensive, Sammy Allen has fallen between the administrative cracks of a local mental health system that can't seem to get its ACT together (continued)

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The clinician performs some counseling, initiates commitment procedures for consumers, and develops treatment plans. The case managers work in the field to develop close relationships with consumers and provide one-stop mental health care: crisis intervention, support with medication, and assistance with housing, basically seeing to it that the consumers are functioning well. The community integration specialists perform the more hands-on tasks, such as teaching consumers to prepare meals or do laundry.

The ACT team's goal is to provide an average of two hours per week to each of the 60 consumers on its rolls. Tony DeFreece, an ACT case manager and "point man" for Sammy Allen, had a caseload of 12 consumers: three in boarding homes, two in jail, one on the streets, and one about to be evicted from his apartment; the other five live with family or in apartments. (DeFreece has since left ACT.)

"We're about the only other option there is," notes ACT psychiatrist Logan. "If we can't do it with Sammy, there's nothing in Dallas County that can."

On March 20 of this year, after a more-than-40-day stay at Terrell State Hospital, Allen was released on a 30-day furlough to ACT. Later that same day, he sits on a couch at the DMHMR Westmoreland clinic, surrounded by several white garbage bags filled with his possessions, a wheelchair by his side. His body odor is overpowering. He rants, loudly and steadily.

Logan meets briefly with Allen, explaining his medications. He mentions that Allen will have to come by the clinic for Haldol injections every two weeks. Sammy says he'll walk away right now if a needle comes near him. Logan hands him a brown paper bag containing four pill bottles, one each of Klonopin (anti-anxiety), Cogentin (to prevent side effects from the Haldol), Procardia (for high blood pressure), and Dyazide (a diuretic).

At this point DeFreece comes over to prepare to transport Allen to Jefferson House, the boarding home at which ACT has arranged for him to stay. According to ACT's Valdez, DMHMR policy doesn't allow his agency to refer a consumer to any of the estimated 50 to 100 legal boarding homes in the Dallas area, most of which house the mentally ill. ACT can only show a client a sheet with a listing of boarding houses, and then let the consumer choose. With Allen, however, this doesn't happen. DeFreece had already chosen a boarding house for Allen while Sammy was in Terrell.

Every step from the clinic couch to the ACT van waiting outside is fraught with tension. When Allen learns that a flight of stairs leads up to Jefferson House, he complains that he can't walk up stairs. DeFreece is skeptical and attempts to placate Allen, who, in turn, rages in proportion to the placating tones. Eventually he's screaming, horrified: "I don't want to be captive! I want to be able to go out, to do things, feed the pigeons, watch traffic!"

DeFreece hurries him along, assuring him that everything will be fine, which prompts Sammy to scold his caseworker, telling DeFreece that he's supposed to be a trained mental health professional--he's supposed to be patient. An argument ensues over who will carry Allen's bags. Sammy repeatedly insists that he's handicapped, that he's sick, that he's slow, that he's old. DeFreece finally relents, agreeing to carry the bags, and the situation cools down. After a moment, Allen says, half to himself, "I'll carry my Bible."

DeFreece responds, gotcha-like: "Oh, if you can carry the Bible, then you can carry the bags."

Allen screams, "Why are you so stupid?"
"Guess it just comes naturally, Sammy."
Allen's fists are clenched, teeth gritted, body shaking. He's about to explode with anger and frustration. "Where are my servants?" he demands. "I'm a king. Where are my servants?"

"You don't have any servants here, Sammy."

Sammy Allen's own account of his past and present mixes outright delusion with hazy autobiographical fragments, all of which is obscured by his anger, his mistrust, and his indifference to the accuracy of information that comes from a lifetime of trafficking in a world in which accurate information has little value for him.

He was the fourth of eight children born to a mother who worked as a maid and a father who worked in the Dallas public school system as a school aide. Sammy was born in South Dallas, but in 1961, when he was 13, the Allens moved to an area in Oak Cliff, the first black family in an all-white neighborhood.

Today the neighborhood is predominantly black. Sammy frequently refers--with both pride and amusement--to living his whole life in the "ghetto." His 76-year-old father, Samuel Allen Sr., still lives in Oak Cliff, along with several members of his extended family, in a home on a quiet street with well-kept houses. His wife, Cornell, died in 1981 of heart trouble.

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