Four days after Virginia police say former Virginia Lt. Gov. Justin Fairfax murdered his wife, Cerina Fairfax, and killed himself, police in Shreveport, Louisiana, say a former National Guardsman shot his wife and a woman who’s been described as his girlfriend and fatally shot eight children. Seven of the children Shamar Elkins killed were his own, those Louisiana authorities say, and the eighth was a cousin of the other seven. Elkins died after police pursued him, and it remains unclear whether he killed himself or was killed by police.
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The two awful crimes have prompted a debate about mental illness and what role it may have played.
The two awful crimes have prompted a debate about mental illness and what role it may have played in these two men reportedly killing — and trying to kill — people so close to them. But if nothing else, the past week’s headlines should remind us of this chilling reality: For millennia, a global culture of patriarchal dominance and violence has caused women to suffer and die. Among the many harrowing statistics in UN Women’s “Progress on the Sustainable Development Goals: The gender snapshot 2025” was this one: Worldwide, 50,000 women and girls were killed by intimate partners or family members — almost all of them men — in 2024. That was 60% of all the women and girls who died of homicide that year.
That means that across the world in 2024, almost every 10 minutes, a woman’s life was taken by someone she knew intimately, and most likely loved. That statistic stands in stark contrast to the 11% of male homicide victims who were killed by their intimate partners or family members.
Ascribing individual-level clinical diagnoses of mental health disorders to men who kill in domestic violence situations is not sufficient to address a societal problem this large. Sure, it might appease us in the moment by stripping away any collective sense of guilt for not raising boys to become men who are emotionally attuned, capable of mentalizing and able to contain their aggressive impulses with a mindset of love and compassion. But when our mental health systems are underfunded and highly stigmatized, where does that shifting of blame lead us, and how does it help us resolve the issue?
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Individual behaviors aren’t just shaped by a person’s intrapsychic temperament and genetics. They’re also shaped by interpersonal and familial relationships, by their communities and by the societal structures surrounding them. As a psychiatrist and public health practitioner, I see the individual, including their personal and community context, and what localized inputs they received. But I also see the population-level determinants that lead to the distribution of diseases and disorders, and in this case the disorder is violence.
I can’t speak to the individual histories of either Fairfax or Elkins, and the opinion I express here shouldn’t be interpreted as a diagnosis of their mental state. But as someone who, since 2024, has served as a trauma mitigation forensic expert on more than 20 cases involving male-perpetrated murder, I can say that in all the cases I reviewed, the men had childhoods characterized by extreme violence inside their households and often in their neighborhoods and communities.
I write my reports for the court — most of them more than 20 pages long — to explain, never to excuse, the perpetrators’ dysregulated, violent behaviors. Obviously, they must be held accountable for the lives they ended and for forever destroying the lives of those victims’ families.
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