Paul Appelbaum, a forensic psychiatrist at Columbia, points out that many young men are asocial and unhappy, spend too much time online, become video-game addicts—but cause no harm. The few dangerous ones are impossible to identify. “Even if we knew who they were or were likely to be, whether they’d actually accept treatment is an open question. Among the hardest people to engage in treatment are young males who may be angry, suspicious, and socially isolated. Coming to a therapist’s office for an hour a week just to pour their heart out doesn’t seem like a particularly attractive opportunity, in general.”
“Adam was not open to therapy,” Peter told me. “He did not want to talk about problems and didn’t even admit he had Asperger’s.” Peter and Nancy were confident enough in the Asperger’s diagnosis that they didn’t look for other explanations for Adam’s behavior. In that sense, Asperger’s may have distracted them from whatever else was amiss. “If he had been a totally normal adolescent and he was well adjusted and then all of a sudden went into isolation, alarms would go off,” Peter told me. “But let’s keep in mind that you expect Adam to be weird.” Still, Peter and Nancy sought professional support repeatedly, and none of the doctors they saw detected troubling violence in Adam’s disposition. According to the state’s attorney’s report, “Those mental health professionals who saw him did not see anything that would have predicted his future behavior.” Peter said, “Here we are near New York, one of the best locations for mental-health care, and nobody saw this.”