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.
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?
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.
Mental health practitioners use what’s called an Adverse Childhood Experiences (ACE) score to determine the amount of trauma — including violence, abuse, neglect and household dysfunction — a person has experienced between birth and 17 years of age. An ACE score of more than 2 or 3 makes a person vulnerable to physical and mental health issues. The highest ACE score is 10. In all the 20-plus cases I reviewed of men who’d committed murder, their ACE scores were more than 8, with all of them indicating early childhoods of extreme physical and emotional abuse. While an ACE score of 8 and above may indicate a higher propensity toward mental illness, due to the consequences of these traumas, that is not the only potential factor that led to their capacity for extreme violence.
According to his brother-in-law, Elkins had recently spent a week and a half at his local Veteran Affairs medical center seeking mental health treatment.
According to his brother-in-law, Elkins, a veteran, had recently spent a week and a half at his local Veteran Affairs medical center seeking mental health treatment. I’ve served as a consultant psychiatrist in the PTSD clinic of a Veterans Administration hospital system. At one point, I served as a research psychotherapist working with African American veterans with histories of crack cocaine addiction. The ACE scores in these veterans was high, and their service-connected PTSD and moral injury was significant.
That isn’t to say that all veterans who have experienced trauma will themselves be violent, but my underlying takeaway from all of these experiences has led me to conclude that “Untreated trauma is the underbelly of violence.” I believe that so firmly that the Institute of Women & Ethnic Studies, the nonprofit I founded in New Orleans, once displayed that message on a billboard outside the city’s jail.
The prevalence of untreated trauma inside a larger society that prizes dominance over asswomen helps explain the UN Women statistic I shared above. It also helps explain why so many women responded to a recent social media question by answering they’d rather be trapped alone with a bear than a man.
Yes, we must adequately fund mental health services and erase the stigma of seeking mental health. But we must also address the sociocultural determinants of violence and our culture that normalizes destructive masculinity while promoting wide-scale gender inequities. This is how we begin to make a crack in this cycle of gender-based violence and move toward creating a more peace-filled and verdant world for all genders and all humanity.
Denese Shervington, M.D., MPH, is a profesor and chair of psychiatry at Charles R. Drew University. She is the founder and CEO of the Institute for Women and Ethnic Studies, a nonprofit dedicated to improving the mental, physical, and spiritual health and quality of life for women, their families and communities of color, particularly among marginalized populations.