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The academic past of Nikolas Cruz, the accused mass shooter at Marjory Stoneman Douglas High School in Parkland, Fla., was littered with red flags suggesting serious emotional problems.

News outlets that have reviewed Cruz鈥檚 disciplinary records and interviewed his teachers paint a picture of a young man prone to violent outbursts and fascinated with weapons. In high school, he spent time in a Broward County public school that specializes in serving students with emotional and behavioral disabilities. The Associated Press has reported that a high school resource officer who was also a sheriff鈥檚 deputy and two school counselors recommended in September 2016 that Cruz be committed for mental evaluation under Florida鈥檚 Baker Act. That law allows for involuntary commitment for mental health examination for at least three days.

The intense focus on Cruz鈥檚 mental health history in the wake of the Feb. 14 school massacre has worried some of those who work directly with students who have mental health needs, such as those receiving special education for an 鈥渆motional disturbance,鈥� the official term used in federal special education law. The classification already carries a stigma, and those students already have some of the worst outcomes among students with disabilities.

Emotional disturbances, also called emotional/behavioral disabilities, are distinguished by their intensity and impact on school performance.

69传媒 in special education for an emotional disturbance are not more likely than their peers to be school shooters. In an exhaustive examination of targeted school shootings between 1974 and 2000, the U.S. Secret Service and the U.S. Department of Education found that while perpetrators commonly described being bullied or persecuted and had thoughts of suicide, they generally did not have a history of mental health evaluations or diagnosis with a mental disorder.

But Cruz鈥檚 known struggles in school have vaulted mental health to the front pages. And the tension between a school鈥檚 responsibility to support students with mental health issues and the need to keep students from harm is now on full display.

Cruz received services both in traditional public school and in a specialized program. After a rocky re-entry to Stoneman Douglas, school officials recommended he return to the alternative placement. But he waived his right to special education services at age 18 with the support of his mother, Superintendent Robert Runcie told the Sun-Sentinel newspaper.

Runcie has ordered a full evaluation of Cruz鈥檚 educational record.

鈥淲hile we cannot undo this heartbreaking attack on our school community ... we can and must do what we can to understand the conditions that lead to such acts, in hopes of avoiding them here and elsewhere,鈥� Runcie said in a statement.

More than 335,000 students nationwide are identified as having an emotional disturbance. Here鈥檚 some of what we know about this population:

69传媒 with emotional disturbances are a small part of the population of students with disabilities.

About 6 percent of students with disabilities are classified as having an emotional disturbance nationally. In comparison, about 39 percent have a specific learning disability, such as dyslexia, and 17 percent have speech and language impairments.

But the numbers don鈥檛 tell the full story. Emotional disorders can be a part of other disabilities; for example, a student with a learning disability could also be coping with anxiety or obsessive-compulsive disorder, both of which fall under the umbrella of 鈥渆motional disturbance.鈥�

And then there are students who may have all the features of an emotional disturbance, but are never identified as having a disability. The 鈥渆motional disturbance鈥� label does not indicate that a student鈥檚 problems are more severe than some other student who never gets that label.

鈥淭here鈥檚 just a lot of randomness in who is able to get through that door,鈥� said Mark Weist, a professor at the University of South Carolina and founder of the Center for School Mental Health. 鈥淚t depends on the school, it depends on the leadership.鈥�

Part of the concern is money, Weist said. 69传媒 are legitimately concerned about how to pay for some services that students might need, so they enact 鈥渢hese artificial barriers to slow down the process.鈥�

69传媒 with emotional disturbances face some of the steepest challenges of students in any disability group.

69传媒 identified with emotional disturbances have lower graduation rates and higher dropout rates than other students in special education. They are more likely than other students with disabilities to face long-term suspension or expulsion.

In the 2016-17 school year, fewer than half of students in this disability category spent most of the day in a general education classroom. And while about 3 percent of students with disabilities overall were in separate schools, 13 percent of students with emotional disturbances were.

69传媒 with disabilities in general, and behavioral disabilities in particular, are more likely than their peers in general education to be both the victims and perpetrators of bullying. 69传媒 with emotional disturbances also face high rates of self-harm.

One school known nationally for its work for students with emotional disabilities and autism is Centennial School, in Lehigh, Pa. The school serves students from elementary through high school who are placed there by several surrounding school districts. The school serves about 100 students each year, with the goal of returning them to their home setting.

Centennial has been profiled for its elimination of restraint, seclusion, and time-out rooms. Instead, the school has clear behavioral expectations and works under the assumption that students will need to be explicitly taught those expectations, as they would be taught math or English.

When students act out, 鈥渨e treat those behavior errors as if they鈥檙e an academic error,鈥� said Julie Fogt, the director of Centennial School. 鈥淲e need to teach them a better way. We鈥檙e not going to punish it out of them.鈥�

69传媒 with emotional disturbances can be suspended or expelled.

Critics often single out special education students in discipline discussions, saying that the law makes it hard for schools to aggressively handle disruptions from students with disabilities.

69传媒 with disabilities are frequently suspended and expelled, however. Federal data from the Education Department found that about 12 percent of students with disabilities faced that discipline, compared with 5 percent of students overall.

Within the universe of children and youth with disabilities, 25 percent of long-term suspensions and expulsions are of students with emotional disturbances, though they represent a fraction of the special education population.

鈥淭he notion that a kid can鈥檛 be disciplined if they have special needs鈥� is incorrect, said Mark Martin, an parent attorney based in Baltimore. 鈥淎 principal can go ahead and do that.鈥� But once a suspension reaches more than 10 consecutive days, the law says that students with disabilities are entitled to a 鈥渕anifestation determination鈥� to see if the problem behavior is tied to his or her disability. Certain offenses, such as carrying a weapon, using or selling drugs, or causing injury, allow schools to unilaterally make the decision to remove a student from a school.

鈥淎 manifestation meeting is not a 鈥榞et-out-of-jail free鈥� card,鈥� Martin said.

And expulsion carries its own risks, said Joseph Erardi, the former superintendent of schools in Newtown, Conn. He joined that district in 2014, two years after the deadly mass shooting that killed 20 students and six staff members at Sandy Hook Elementary School.

He led a group of superintendents who wrote a paper offering best practices for school leaders around mental-health issues in students.

鈥淥ne of the greatest takeways is that social isolation at any point for a complex youngster is clearly an opportunity for that child to move into a more difficult space in his or her life,鈥� Erardi said. Expulsion of such a student is 鈥渆xtraordinarily counterproductive to the best interest of that child.鈥�

There are successful tools for working with these students. But help often comes late in a student鈥檚 academic career.

A little over half, 52 percent, of students with emotional disturbances are 13 to 17 years old. For the special education population overall, it鈥檚 34 percent.

There鈥檚 a couple of reasons behind that, said Sharon Hoover, an assistant professor of child and adolescent psychiatry at University of Maryland School of Medicine, and the co-director of the Center for School Mental Health. Some mental-health issues manifest themselves in adolescence, and some student problems aren鈥檛 officially diagnosed until they鈥檙e hard to ignore鈥攁nd hard to treat.

But schools have developed ways to support students with mental health needs, Hoover said. One model used in Baltimore County, Md., brings community-based mental health providers directly into the schools so that they can provide counseling and other support services.

Having more trained counselors available, plus universal screening for mental health concerns 鈥渁re not easy fixes, but they鈥檙e the natural solutions,鈥� Hoover said.

鈥淭here are a lot of interventions that have demonstrated success,鈥� Hoover said, and they don鈥檛 involve harsh discipline or arming teachers鈥攕uggestions coming from the White House. But in the immediate aftermath of a tragedy, those interventions can be forgotten, she said.

鈥淲e need to create conditions for kids to feel connected.鈥� she said.