The Quiet Crisis: Untreated Mental Illness and Violence

The case of Thomas Crooks, the Pennsylvania man who tried to assassinate Donald J. Trump at a rally in Pennsylvania last year, is a stark reminder of the devastating consequences of untreated mental illness. As detailed in The New York Times,^1,2 Crooks, a bright engineering student, showed signs of deteriorating mental health—talking to himself, dancing in his bedroom at all hours, searching online about depression—yet no intervention came in time to prevent his descent into violence. His story underscores a critical issue: Parents must recognize and act swiftly when children show psychiatric distress.³

A Brain in Pain

I spent 20 years studying the deeper spiritual and psychoanalytic origins that underlie mass shootings and terrorism.⁴ Our research team, which consisted of a death-row lawyer and psychiatrists from Stanford and the Icahn School of Medicine, found that many perpetrators of mass shootings not only suffered from undiagnosed mental illness but were, as children, psychologically discarded by society. In many cases, their social unease caused them to separate from peers for self-protection, which only made them more isolated—and ripe for radicalization for violence online. Most assailants had clear psychiatric warning signs that went unnoticed and untreated. Many struggled with early-onset schizophrenia or other serious brain illnesses.

One of the most heartbreaking patterns in our team’s psychiatric research⁵ is how often the warning signs were obvious to someone. Parents. Neighbors. Classmates. Even online followers.

Let me be clear: Most people with mental illness are not violent. But when serious psychiatric conditions like psychosis or suicidal ideation go untreated—especially in marginalized kids—the risk increases dramatically.

Rethinking Responsibility

Thomas Crooks’s story is a painful lesson in the cost of inaction. According to the Times investigation, Crooks’s father noticed his mental health declining in the year leading up to the shooting, yet took no action. Parents must be vigilant and proactive to seek emergency psychiatric care when their children show signs of distress. The stakes are too high to ignore. Early intervention saves lives.

Parents play a central role because they can interact with and observe their troubled child most intimately. When a child confides that they hear voices telling them to kill, or that they fantasize about committing violence, it’s never a joke. It’s a psychiatric emergency. Dismissing it—or, worse, mocking it, as parents of the Oxford High School shooter did—can be fatal. In the case of the Oxford High School shooting in Michigan in 2021, the assailant’s parents were aware of his homicidal ideation and mental health struggles. They bought him a gun anyway.

The Silent Crisis in Youth Mental Health

Nearly half of all lifetime cases of mental illness begin by age 14, yet stigma and denial prevent early intervention. Crooks’s father was aware that mental illness ran in the family.⁶ Yet he failed to seek urgent psychiatric care for his son. Sadly, this is a recurring story. Many families struggle to acknowledge the severity of their child’s mental health issues, often waiting until a crisis forces action.

The Consequences of Delayed Intervention

When psychiatric care is delayed, the risks multiply. Children suffering from untreated depression, anxiety, or psychosis may withdraw, self-harm, or, in extreme cases, lash out violently. At the very least, untreated schizophrenia often requires more extreme forms of treatment, can take longer to resolve, and may cause lasting damage to the brain. The lack of early intervention can lead to irreversible consequences, not only for the individual but for society at large.

Crooks’s unraveling was gradual but largely unnoticed. He stockpiled explosives, used encrypted networks, and exhibited behaviors that, in hindsight, were clear indicators of a deteriorating mental state. His case exemplifies how untreated mental illness can escalate into tragedy.

What parents must do:

1. Recognize the Signs: Parents must educate themselves on symptoms of mental illness, including withdrawal, erratic behavior, excessive mood swings, and expressions of hopelessness.

2. Seek Immediate Help: If a child exhibits concerning behavior, waiting is not an option. Emergency psychiatric care, therapy, and medical intervention can prevent escalation.

3. Break the Stigma: Many families fear the label of mental illness, but seeking help is not a sign of weakness—it is an act of love and responsibility. A parent who did not seek emergency medical attention for a child with a broken arm or appendicitis would be considered liable for criminal neglect, and not seeking immediate help for a child showing clear warning signs of mental health issues is just as neglectful.

4. Advocate for Better Access: The mental health system is often difficult to navigate. Parents must push for better resources in schools, communities, and health care systems to ensure timely intervention.