In September, Routh had been transported to a psychiatric hospital after he threatened to kill himself and his family, and he later told officers that he suffered from post-traumatic stress disorder, Lancaster police records show.
...the VA failed to treat Routh and keep him in the mental hospital. He was released two days before the shooting against his families wishes (after he threatened to kill them).
So.... Is PTSD to blame?
Sounds like maybe he was insane.