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There’s No Mental Health System That Can Stop Angry Young Men Like the Buffalo Shooter

The Buffalo shooter underwent a psychiatric evaluation in June 2021 after making threatening comments in school. Blame is falling on the school, police and mental health professionals for letting him go — but the fact is, our system was never designed to catch a mass killer

Many details remain undisclosed in the story of the 18-year-old Buffalo shooter, but one of the most vital revelations is that he was pulled from school on June 8, 2021 for a psychiatric evaluation, and ultimately was observed for a day and a half before being discharged. 

The incident unfolded after Payton Gendron made threatening comments at his school, Susquehanna Valley Central High in Conklin, New York, about how his graduation project was going to involve murder-suicide. 

He didn’t mention targeting his classmates or having access to firearms, but the comments were severe enough for a school employee to report Gendron as a threat. The normal protocol would be for a teacher or administrator to bring a potential threat to the attention of the principal, who may then contact law enforcement to conduct a welfare check at home, says Aiden Ryan, a spokesperson for the school. This could trigger a psychiatric hold and evaluation under New York’s emergency mental health laws, with Gendron being transported to a local inpatient psychiatric facility for observation. 

The town of Conklin is so small that it doesn’t have a hospital — instead, you have to drive 20 minutes to UHS Binghamton General, which coincidentally has the only emergency mental health care facility in the City of Binghamton. (The hospital didn’t reply to multiple requests for comment on the normal discharge protocol and whether Gendron was evaluated there.) 

But after his overnight stay at a facility, Gendron was no longer deemed a threat to himself or others and released. And although he declined to give further details, Ryan noted that in order to resume attending classes, a student in his position would have had to meet with Susquehanna High’s in-house social worker after returning from the hospital. 

All of it seemingly went off without a hitch, with the young man graduating from school and enrolling in community college while quietly penning his “manifesto” and planning his assault

It’s common for us to collectively fixate, in hindsight, on the bits and pieces of evidence that a mass murderer was struggling with their mental health — a diagnosing of the past based on context from the present. It’s why the reaction in the aftermath of the shooting has been predictable, with headlines blaring about his psychiatriatric evaluation and wondering why existing protocols, including “red-flag” gun laws, didn’t stop the tragedy from unfolding.

But this framework, and the assumption that Gendron was a teenager who “slipped through the cracks,” does a disservice to the bigger problem at hand: Our mental health system isn’t merely flawed when it comes to stopping aggrieved young men before they pull the trigger. It’s become crystal clear that the system was never designed for this problem — and instead of generating radical new ideas on how to help young men, we’re still stuck using the wrong tools. 

Even after three decades of tragedies, America has a poor understanding of the link between mental health, masculinity and mass violence. What is obvious today is that relying on police and emergency mental health protocols to catch lone-wolf attackers will never be enough. The Buffalo shooting is merely the tragic side effect of a broad social illness, one that requires more than a ban on “assault weapons” or involuntary psych holds to fix. 

“The existing mental health system and these 24- or 48-hour emergency evaluations are really designed to identify and help people who are at imminent risk of hurting themselves or others, and they rely on those folks being fairly honest,” says Andrew Smiler, a licensed therapist and expert on masculinity. “The professionals in those settings aren’t tasked with screening people’s social media accounts, for example. A school social worker, too, isn’t trained in the kind of forensic assessment that’s needed to spot a potential mass murderer in advance. Especially if the subject is trying to hide their intentions.” 

In hindsight, it’s obvious that the Buffalo shooter needed long-term counseling: In his private Discord chats, he reflected openly about his degrading mental health. “I have wondered if I’m mentally ill, and that’s why I’m planning the attack like I am now. Why is it that nobody else except for a few decided to commit to an attack like this? They had the same reasons I had,” he wrote on February 11th. “The past 7 years have hurt so much, I think I’m ready to abandon it all.”

“My parents know little about me… Promise me if you have a child you will be there and you will be close, be a friend to your child and make sure they know that you will always help them,” he wrote on February 22nd. 

“Decent mental health services for all would be nice,” he wrote on March 1st. 

“I’ll admit my mental health has seriously degraded these past few years, especially in the last few months,” he wrote on April 27th.

But these admissions, and even many forms of violent ideation, don’t necessarily mean the subject must be held against their will and evaluated in a hospital as a potential mass murderer — not when there’s so many angry men out there who are just struggling with depression. The root problem isn’t even mass killings by aggrieved men, which remains statistically minor compared to the slew of, say, domestic violence assaults and firearm suicides.

Instead, the root problem we’ve seen again and again, from the Isla Vista incel to the racist El Paso shooter to Gendron, is that young men are increasingly disillusioned by society’s path and develop a long list of grievances, fueled by online discourse that thrives on virality and extremism. 

While there are many subcultures around inceldom, white supremacy and anti-feminism, the specific angle doesn’t really seem to matter to the end result: Bloodshed in the name of legacy and revolution, at the hands of men who see modern life as a dead-end. Even cases without a sensational “manifesto,” like the Sandy Hook shooting committed by a 20-year-old, still have the same markers of a young man who struggled to find a place in the world, and eventually chose cathartic violence as a salve. 

A 2016 report published by the American Psychiatric Association looked into the case studies of five male mass murderers, and found common threads: Bullying and isolation in childhood, paranoid traits such as suspiciousness and a worldview that reflected that paranoia, leading to beliefs that people are “generally rejecting and uncaring.” 

What it didn’t find was a link between mass shootings and the kind of mental disorders that should trigger involuntary psychiatric holds and red-flag laws: “Few perpetrators of mass shootings have had verified histories of being in psychiatric treatment for serious mental illness. Rather, detailed case analyses reveal that individuals who commit mass shootings often feel aggrieved,” the authors note. “Thus, in most cases, it cannot fairly be said that a perpetrator ‘fell through the cracks’ of the mental health system. Rather, these individuals typically plan their actions well outside the awareness of mental health professionals.” 

Psychiatrist and mental health expert Reef Karim observes that men who are planning a violent act can be categorized into three groups: Those who are “in pain” after a real or perceived traumatic incident that incites anger; those who are “misunderstood” and unable to share their challenges with anyone substantively; and those who are “sociopathic” and unable to feel shame or empathy while considering an attack. 

For the first two groups, a proper intervention at the right time could be all it takes to quell potential violence, Karim says — but the problem is that it requires special training to really spot the difference between these groups and get someone into treatment. “That’s why this is challenging,” Karim says. “You need front line teachers and staff trained in psych, you need professionals available for further assessment, and you need law enforcement trained in psych to work hand-in-hand with psychological professionals.” 

Considering the huge dearth of mental health resources on all those fronts, we’re a long way from having the kind of psychological competency necessary in schools, workplaces and policing — but that’s the kind of social revolution required to shift the course of young men who struggle with questions of purpose. Instead, politicians and pundits alike keep coming back to the same punitive measures, whether it’s for restrictive mental health laws or for domestic terror statutes and unethical police surveillance to catch more potential suspects.

There’s already plenty of evidence that these bandages won’t stop the bleeding, given how complex the ills of lonely men are. This isn’t a mental health crisis in the way society imagines: Research shows that people with mental disorders are not more likely to commit violent acts, and indeed are disproportionate victims of violence. Instead, mass killings are as much an issue of politics, economics and “cultural scripts” as they are about clinical mental health. 

“The vast majority of murders, in general as well as mass murders, are done by males. Yet the vast majority of people who work in therapy are female. It illustrates how there’s a missing piece in cultural competence here when we work with boys and men and try to understand masculinity,” Smiler says. “We have an odd dynamic in the mental health field where we’re trying to identify these one-in-a-million men who want to shoot up a public space, when the mental health field generally doesn’t have a good basis in understanding men at all.” 

As the 2016 report published by the APA observed, psychiatric illness remains “far from the most significant or consistent finding” when trying to understand mass violence. The authors instead conclude that “increased attention should be paid to sociocultural factors associated with mass shootings,” with the goal of seeking other interventions beyond the framework of emergency mental health laws. Five years later, another report from Havard doubled down on that statement, urging that “researchers must abandon the starting assumption that acts of mass violence are driven primarily by diagnosable psychopathology in isolated ‘lone wolf’ individuals.” 

In other words, the Buffalo shooter wasn’t someone who fell through our proverbial social safety net. He was always going to find his way through — and the public narrative obsessing over why the “mental health system” failed does nothing to provide solutions for the future.