A report released today by the Office of the Child Advocate on the Sandy Hook School shootings finds missed opportunities and failures by health care providers to fully realize the depth of Adam Lanza’s mental illness.

Professor Julian Ford with the Center for Trauma Recovery and Juvenile Justice at UConn Health was one of six primary authors of the 112-page report released Friday.

The report details how months prior to the Newtown tragedy, Adam Lanza became more and more disconnected from himself and his family and the mental health providers that might have been able to help him.

“Lanza became so severely disconnected from his family, school, the social world outside his room (except the ersatz virtual cyberworld), and his own awareness of himself as a human being with a physical body that he apparently could not distinguish between fantasies about mass murder and the actual act,” said Ford. “Exactly why he actually acted in this heinous manner cannot be determined, but his inner turmoil and the isolation that his mother tragically encouraged and enabled (and that his father deferred to), in combination with access to weapons, proved to be a fatal combination. This kind of psychological disconnection, or dissociation, is a serious problem for tens of thousands of children and young adults who will never commit violent acts but who suffer severely unless they – and their families – are provided with comprehensive school, pediatric, mental health, and social services.”

The report outlined many recommendations including focusing on how to identify and assess youth from a very young age, and the necessity of cross-system communication among professionals charged with the care of children.

“To restructure legal mandates (with provisions for meaningful and accessible funding) for mental health and social emotional rehabilitation services so that schools and pediatric providers are better prepared to access expert guidance and identify and get comprehensive help for children with complex social emotional problems and their families,” explained Ford.

Key findings

• Lanza presented with significant developmental challenges as young as 3 years old, including communication and sensory difficulties, socialization delays, and repetitive behaviors.
• There were early indications of his preoccupation with violence, depicted by extremely graphic writings that appeared to have been largely unaddressed by schools and possibly by parents.
• In 8th grade, Lanza’s anxiety began to further impact his ability to attend school and he was placed on “homebound” status.
• The Yale Child Study Center recommendations (where Lanza was evaluated at age 14) for extensive special education and rigorous therapeutic support went largely unheeded.
• Lanza (and his mother) resisted medication for treatment of his anxiety and obsessive compulsive disorders.
• Lanza and his parents did not appear to seek or participate in any mental health treatment after 2008.
• Lanza became increasingly preoccupied with mass murder, encouraged by a cyber-community – a micro society of mass murder enthusiasts. Ford says this cyber world may have added to his feeling of being disconnected and “losing a sense of people as real human beings.”
• In the months before the shooting, when his mother noted he would not leave the house and seemed despondent, it’s not clear that any measures were taken to curtail his access to guns.
• Lanza was anorexic at the time of death, measuring 6 feet tall and weighing only 112 pounds.

The report stresses concern over siloed systems of education, physical health, and mental health care for children, and the need to assist parents with understanding and addressing the needs of children with complex developmental and mental health disorders.

Ford pointed out that when a child is deeply troubled, there is a tendency for families to circle the wagons and put up the fences and deal with it alone. “Parents need to view the mental health system not as challenging them but as supporting them,” he said.

Ford and the other authors spent months collecting and reviewing records related to the life of Lanza – including his medical, mental health, and education records, as well as un-redacted state police and law enforcement records. They reviewed thousands of pages of documents, consulted with law enforcement and members of the Child Fatality Review Panel, conducted interviews, and incorporated extensive research to develop the report’s findings and recommendations.