As early as April 1999, following the Columbine shootings, there were signs that Cho was capable of violent thoughts, if not actions. He wrote a paper in English class that expressed thoughts of suicide and homicide, and a desire to "repeat Columbine," although he did not mention specific individuals or targets.
The incident prompted the school to urge Cho's parents to have a psychiatric evaluation for their son, which led to the diagnosis of mutism and depression, for which he was started on a short course of paroxetine (Paxil).
But information about Cho's medical history was never passed up the chain to Virginia Tech. And during his time there, repeated "red flags" were not recognized as symptoms of a larger problem the panelists said.
Some of the signs of trouble looming included Cho's playing with knives, uncooperative and disruptive behavior in the classroom, students who skipped classes to avoid being near him because they were afraid of him, disturbing or bizarre text messages sent to female students, and an involuntary commitment to a hospital for expressed thoughts of suicide.
