He's been described as mentally ill, unstable, a loser, a loner.
Although many have raised concerns about the mental history of alleged Tucson gunman Jared Lee Loughner, others have questioned what realistically could have been done to help him before his demons caused him to allegedly gun down six people and wound 14, including U.S. Rep. Gabrielle Giffords.
"Hindsight is 20/20," said Kristina Ragosta, legislative and policy counsel for the Treatment Advocacy Center, an arm of the Maryland-based Stanley Medical Research Center. "There's enough blame to be placed around it seems."
Ragosta acknowledged that it is impossible to gauge whether treatment for mental illness would have prevented Saturday's shooting.
But like with the shooting tragedies in the past at Columbine and Virginia Tech, those who knew the accused gunman immediately began pointing at his bizarre and eccentric behavior in the days after the rampage at a Tucson Safeway supermarket.
Former classmates, friends and neighbors have cited examples of behavior they called erratic, disturbing, even frightening.
"I told my mother he was a serial killer the first time I saw him," neighbor Jason Johnson told ABC News.
What those around him may not have known, Ragosta said, was that Arizona is one of 44 states that have civil confinement laws, meaning that a family member or responsible adult could have petitioned a court to confine Loughner for treatment if they thought he was a danger to himself or others.
While each state has different protocol for civil confinement, Arizona's standards call also for the patient to be unable to perform basic physical needs or be likely to suffer severe mental or physical harm without treatment and likely to benefit from treatment.
"My heart breaks when I hear there were people that sat on the other side of the room from him because they were scared of him because he was that unstable," Ragosta said. "At the end of the day, this suspect sadly could have benefited by court ordered treatment."
Pima County Sheriff Clarence Dupnik told ABC News that campus police had to get involved at the college where Loughner once attended after a number of complaints.
"All I can tell you is that teachers and fellow students were concerned about his bizarre behavior in class to the point where some of him were physically afraid of him," Dupnik said. "He was acting in very weird fashion to the point where they had several incidents with him to the point where law enforcement at Pima College got involved and they decided to expel him. And they did."
Loughner has often been described as a loner who grew up in suburban Tucson, the only son of Randy and Amy Loughner. Those who knew him say he morphed from a typical teenager into one that expressed radical thoughts.
Later, he was said to have developed somewhat of an obsession with Giffords after she refused to answer a riddle-type question posed by Loughner at one of her events.
Neighbors say he kept to himself.
In most cases where the mentally ill are considered for confinement or treatment, Ragosta said, it comes after a phone call from the person's family.
But Lynn Riach, who has lived across the street from the Loughners said she felt "really sorry for Jared" because she thought he grew up in a "negative environment."
Riach described Randy Loughner as "an angry man."