How mental health played a role in high-profile mass shootings

Some motives remain unknown

Pulse shooter Omar Mateen, Aurora theate gunman James Holmes and accused Marjory Stoneman Douglas High School shooter Nikolas Cruz.

The U.S. leads the world in mass shootings. Four of the deadliest killing sprees in the last five decades happened in 2018 alone. About 70 percent of active shooter incidents end with the suspect’s death either by suicide or by action from law enforcement officers. In the aftermath of every mass shooting, questions inevitably arise about the suspect’s mental state.

Here is a brief breakdown of several high-profile cases, background information on the suspect and what is known about the gunman’s mental health. Among them, the deadliest mass shooting in U.S. history, the school shooting that sparked a national movement, and the tragic night in Orlando that changed Central Florida forever. 

Omar Mateen and the Pulse nightclub shooting

On June 12, 2016, at 2:02 a.m., Omar Mateen opened fire at Pulse nightclub in Orlando, killing 49 people and injuring 50 others. Mateen called 911 to tell them his name, what he did and why: He was a follower of the Islamic State group. Mateen was killed in a shootout with law enforcement during what was, at the time, the worst mass shooting in U.S. history. Pulse was one of Orlando’s most popular gay bars, although a motive for the shooting has not been determined. 

The 29-year-old married father lived in Port St. Lucie, Florida, where he worked as a security guard at a courthouse and at the security gate of an upscale gated community just outside Orlando. He was born in Flushing, New York, to Afghan refugees. Mateen wanted to become a police officer and posted photos of himself in New York Police Department T-shirts, although he had no actual link to the NYPD. Mateen had a 3-year-old son from his second marriage to Noor Salman. In March 2018, Salman was accused of aiding and abetting in the Pulse attack and obstructing justice by lying to FBI investigators but was found not guilty in federal court.

Despite claiming allegiance to the Islamic State, there was no evidence that Mateen had ties to terrorist groups. There were, however, early signs of a troubling temper and abusive behavior. Sitora Yusifiy, who was briefly married to Mateen, described her ex-husband as abusive and said he beat her repeatedly. “He was not a stable person,” she told The Washington Post. “He beat me. He would just come home and start beating me up because the laundry wasn’t finished or something like that.” Yusifiy also mentioned Mateen’s mental health, speaking publicly one day after the shooting. Yusifiy told reporters, “A few months after we were married, I saw his instability and I saw he was bipolar and get mad out of nowhere." Daniel Gilroy, a former co-worker, told Florida Today, “This guy was unhinged and unstable." Gilroy said Mateen even talked about killing people. Mateen had a gun license in Florida and was able to obtain two weapons legally shortly before the attack.

Nikolas Cruz and the Marjory Stoneman Douglas High School shooting

Nikolas Cruz is escorted into a Broward County courthouse for his arraignment on March 14, 2018.

Former student Nikolas Cruz is accused of killing 17 people with an AR-15 at Marjory Stoneman Douglas High School in Parkland, Florida, on Feb. 14, 2018. Seventeen other students and teachers were injured. The shooting turned survivors into activists and sparked a national movement against gun violence, including a nationwide walkout, the March for Our Lives in Washington, D.C., and a bill approved by Florida House representatives that raised the age for buying firearms to 21. The bill also required a three-day waiting period for purchases and allowed some school staff members to be armed on a volunteer basis.

Video was released in August 2018 of Cruz describing to authorities "the demon" and "voices" that drove him to kill 17 students and faculty. Cruz is seen sobbing while speaking with his brother and whispering, "Kill me" to the camera suspended in the interrogation room. Cruz is also seen slapping and punching himself when left alone. Offered a glass of water, he declines, saying, "I don't deserve it." The 19-year-old told a Broward County sheriff's detective he wanted to kill himself. He also spoke of "a voice" and a "demon" that told him to "Burn. Kill. Destroy." 

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Cruz’s attorneys have pointed to mental illness as a motive in the shooting, saying that the teen had depression after the death of his adoptive mother. The woman who cared for the alleged Parkland school shooter after his biological mother’s death said she did everything she could to keep him calm and away from guns. 

Rocxanne Deschamps held a news conference in New York about a month after the shooting. Cruz and his brother, Zachary, moved in with Deschamps after their mother died of pneumonia in November 2017. Deschamps described her efforts to alert authorities about Nikolas Cruz prior to the mass shooting. "I did everything I could to warn law enforcement about what could happen. I wanted to protect, not only my own children, but also anyone else who might be at risk of being harmed," she said. The boys' mother, Lynda, was also afraid of Nikolas and said he had once held a gun to her head, Deschamps told reporters.

Stephen Craig Paddock and the Las Vegas Mandalay Bay concert shooting

On Oct. 1, 2017, The Mandalay Bay Resort and Casino shooting in Las Vegas by Stephen Craig Paddock, 64, became the deadliest mass shooting in modern U.S. history. The shooting of concertgoers at the Route 91 Harvest country music festival on the Las Vegas Strip left 58 people dead and 515 injured. Police say Paddock opened fire on festival attendees from his 32nd-floor suite. He killed himself just before authorities stormed his room. His motive is still unknown.

People run for cover at the Route 91 Harvest music festival after a gunman opened fire on Oct. 1, 2017, in Las Vegas.

The gunman’s brother, Eric Paddock, lives in the Orlando area. He told reporters he had spoken with police about the shooting, which has left the family "dumbfounded." He did not mention anything about his brother’s mental health.

According to The New York Times, Paddock’s primary care physician in Las Vegas said he had last seen the gunman as a patient roughly a year before the shooting. He told officials that he suspected Paddock had bipolar disorder.

Dylann Roof and the Charleston Church shooting

A federal jury sentenced Dylann Roof to death in January 2017 for killing nine black church members in a racially motivated attack. In a jailhouse journal entry six weeks after the 2015 shooting, Roof wrote, “I would like to make it crystal clear, I do not regret what I did. I am not sorry. I have not shed a tear for the innocent people I killed.”

Family members of the victims of a shooting at Emanuel AME Church comfort one another during a memorial service, Friday, June 19, 2015, in Charleston, S.C. (AP Photo/David Goldman)

According to CNN, Roof’s lawyers cited a competency hearing in which a doctor determined their client has "social anxiety disorder, a mixed substance abuse disorder, a schizoid personality disorder, depression by history and a possible autistic spectrum disorder."

Roof was convicted of all 33 federal charges against him. During sentencing, he represented himself and told jurors he did not have a mental illness. He did not express any remorse or ask that his life be spared. Roof told FBI agents he wanted to bring back segregation or perhaps start a race war with the slayings.

The Justice Department says he is the first person to get the death penalty for federal hate crimes.

James Holmes and the Aurora theater shooting 

Holmes' trial began in April 2015. His 165 charges included murder and attempted murder charges. He pleaded not guilty by reason of insanity.

A jury convicted James Holmes of first-degree murder charges for killing 12 people and wounding 70 others when he opened fire at a Colorado movie theater in 2012 during a midnight showing of "The Dark Knight Rises."

A colorful sign decorates the entrance of the Cinemark Century 16 movie theater in Aurora, Colo., on Wednesday, May 11, 2016. During the May 10, 2016 start of a civil trial over whether Cinemark should have foreseen the 2012 deadly shooting attack here, an attorney for the cinema chain argued that the gunman was so determined that no security measures could have stopped him. (AP Photo/Brennan Linsley)

According to CBS News, Holmes claimed he was insane during the shooting and therefore not guilty of murder. Holmes methodically planned the killings, but defense lawyers claim he was schizophrenic and in the grips of a psychotic episode. Two state-appointed forensic psychiatrists who evaluated Holmes determined that he was legally sane, despite severe mental illness. 

Holmes spent months collecting an arsenal of weapons and body armor. He doodled detailed plans for the shooting in a spiral notebook. Holmes was sentenced to 12 life sentences for the murders plus 3,318 years for the attempted murders of those he wounded.