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

The larger point is that there are times when Allen is being admitted to a psychiatric emergency room, involuntarily medicated, and classified as violent based on the word of a boarding house desk clerk who may not have liked the fact that Allen disobeyed one of the house rules. This is typical of Sammy's existence within the local mental health system. He has left in his wake a paper trail filled with misinformation and hearsay, a collection of providers who can't keep track of the details of his life, and the overriding assumption that because he's so antisocial, he's probably in the wrong anyway.

And yet despite 26 years of orders of protective custody, involuntary commitments, and psychiatrists testifying to the fact that Allen is dangerous and violent, no documented evidence exists that he has ever physically harmed anyone.

"I don't disagree with removing him from the community when he is even perceived as dangerous, either to himself or to other people," observes Larry Sadberry. "But I know personally that there's been times when he's just told me to go away and don't come back, and don't 'f' with him--and I did that. And then the next time I heard it, he ran after me with a knife and threatened to kill me, and basically things got really blown up out of proportion."

"I'm not dangerous," Allen says. "I'm an old man. Who am I gonna hurt?"

On the night of March 31, after Allen has been released from the Parkland ER, he sits by himself in a bus shelter a block away from Jefferson House. He wears plastic, rose-colored glasses given to him by the hospital. Behind the glasses, his eye is dripping and encrusted with pus.

Earlier he had been in a thrift store located near Jefferson House, when he felt the need to urinate. Because he didn't want to embarrass himself by relieving himself in the store, he hurried outside, where he urinated on himself. Now he's waiting for his pants to dry so he won't get yelled at by the people at the boarding home. He believes the urination problem is caused by his medication, although he doesn't know which medication.

One week later, on April 6, Allen is at Jefferson House, flush with money from his SSI check, a melted chocolate bar in his pocket. He's being yelled at repeatedly by the desk clerk to be quiet, to lower his voice. Sammy rages back arrogantly. When a resident asks no one in particular for a cigarette, Allen goes on a rampage, calling the resident a bum, accusing him of never working in his life, and mockingly repeating "Gimme a cigarette, gimme a cigarette." The resident cowers and goes away.

On April 9, he sits in his room, commenting that he's trapped. The seat of his pants is split completely apart, he's not wearing underwear, and the smell is terrible. Allen notes that Richard Smith, the ACT team master clinician, and another ACT member have just left, and that they gave him a cigar (he likes cigars). When asked why he didn't tell the ACT members about his pants, he says he doesn't know why--says he's too weak-minded.

He puts on a dirty trench coat and walks to a local thrift shop, screaming and cursing at the passing cars that make it difficult for him to cross the street. (Allen says that sometimes buses won't stop for him because some of the drivers know him, and he's too much of a burden to have on the bus.) In the store he's confused, belligerent, and nasty, sometimes screaming violently. After considerable effort, he manages to buy a pair of pants. On the walk back to Jefferson House, he says, "I didn't mean to...Um, I didn't mean nothing by..." He fumbles for words, trying to form an apology, and finally winds up quoting scripture to suggest how people should respond to him: "Soft words turn away wrath."

On April 15, Allen is thrown out of Jefferson House. The way Sammy Allen tells it, it was his decision to move. But a manager at the boarding home claims that Allen was "too loud and obnoxious."

For the 26 days Allen lived at Jefferson House, he slept on the same urine-soaked sheets. For 26 days he wore filthy, foul-smelling clothes, and his laundry was never done. Untrained boarding house desk clerks dispensed his medication. And he failed to show up at Parkland for follow-up care on his infected eye because he depended on a desk clerk to coordinate his appointment, which didn't happen. Three weeks later, he still had not been to the eye doctor.

On even the most basic level, there was not even a scheduled time for an ACT team member to meet with Allen at the boarding home. ACT members came by whenever they could and hoped that Sammy would be there. Allen never had any idea when they would be stopping by, and if he really cared about seeing them--which he didn't--he would have had to sit in the boarding home all day until they showed up.

This April 2 entry in an ACT consumer activity log typifies the care Allen received during the time he lived at the boarding house: "Went to see Sammy to monitor progress. He stated that he does not like living @ THE BH [BOARDING HOME] AND WOULD LIKE TO GO TO TERRELL AND REVOKE HIS FURLOUGH. I STATED THAT OUR JOB WAS TO KEEP HIM OUT OF THE HOSPITAL. HE GOT BELLIGERENT AND STATED THAT HE DIDN'T WANT TO SPEAK TO ME ANYMORE. I LEFT AT THIS TIME AND INFORMED HIS CM [CASE MANAGER] OF THE SITUATION."

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