Another mass shooting has occurred. Another angry young man with a powerful gun has lashed out killing multiple people and inflicting pain on all of us.
As a child psychiatrist, I currently treat children and adolescents from the ages of three to 17 in three different clinics. My patients cover a wide socioeconomic, psychiatric and developmental spectrum. What they all share in common is access to mental health care.
It is not unusual for teenage boys to become angry or irritable when they are depressed. They don’t get sad, they get mad. Over the years I have treated a number of teenage boys as patients who were referred to me because they threatened to shoot up their school. They all have had either depression or PTSD or both. Some have experienced severe abuse, all have experienced emotional neglect.
They are all doing very well. In fact, this past week I saw two different teenage boys for routine follow up visits who were referred to me back in 2018 because they had made those threats. After treating them for their depression the real boys emerged: wonderful kids I would be proud to claim as my own sons. Because these boys are fortunate enough to have access to mental health services, they will most likely keep seeing me routinely until they turn 18. I am confident these boys will become wonderful young men who will make the world a better place.
I wish this mass shooter had lived so we could learn what happened. I sincerely doubt he had access to the services my patients have. I would not be surprised to find out he experienced trauma. I’ve already read that his mother had a substance use disorder. As a child psychiatrist, I know this often leads to the children experiencing abuse and neglect. It’s obvious he had a lot of anger about this because he posted videos of himself screaming at his mother. It appears the family experienced significant financial duress. He had a speech impediment for which he was bullied for years, which means he most likely did not receive the intensive speech therapy he needed. He had to wear old, unattractive clothes to school. His father worked outside of town, and rarely saw him. This was a kid who experienced a lot of pain that no one in his life addressed.
It sounds as if he became very dependent on his phone. During the pandemic shutdown, I learned that a number of my patients didn’t have wifi and were using their cell phones to access the Internet and wracking up huge bills. Almost all my patients have special needs accommodations, so I was able to get these kids back into in person school pretty quickly. I have read nothing about this shooter having had those accommodations. Graduation week is a painful period for teenagers who have dropped out of high school. I would not be surprised to learn he used his cell service to access the Internet, his only social outlet, and then his grandmother threatened to turn it off when she got the bill, at a time when he was feeling especially isolated. All of this added up to make for one very angry young man.
It is an oversimplification to say this shooter was “mentally ill.” He was neglected and abused and felt increasingly trapped. He was forced to survive without a lot of basic necessities. We as a society create these situations. And then we demonize the shooters so we can excuse ourselves.
And after completely neglecting these boys, we let them get their hands on an AR-15.

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