Virginia Tech shooter Seung-Hui Cho's mental health records released today by the university depict a young man in crisis who seemed to learn to mislead doctors and counselors trying to help him.
 
The records show that in the 15-day period in the winter of 2005 between Cho's first triage appointment at Cook Counseling Center on Nov. 30 and his discharge from Carilion Clinic St. Alban's Hospital on Dec. 14, his diagnosis changed drastically.
 
The image of Cho painted by the documents swings wildly from a young man with ongoing psychological and behavioral problems to a mentally ill psychiatric patient deemed to be "an imminent danger" to himself and others to a college student with no history of problems suffering from "acculturation issues" and "stress of college life" who required "some outpatient counseling."
 
The documents show only one instance, the first Cook session with Maisha Smith on Nov. 30, when Cho honestly related his troubled history and hinted at his growing turmoil.
 
E-mail correspondence beginning in October between Cho's English professors, including Lucinda Roy, show escalating tensions with his classmates and teachers. Virginia Tech Police Department records show two instances of alleged harassing behavior towards two different women. The first harassment complaint was made on Nov. 27. Three days later, Cho visits the Cook center for the first time.
 
According to a "triage form" filled out by Smith on Nov. 30, Cho reported a depressed mood and problems with social interaction that had been ongoing for two years. Cho also told Smith he "always" sufferred from panic attacks and anxiety when talking to people. Cho reported that he had recently developed difficulty concentrating and was experiencing a lack of appetite. He reported ongoing problems communicating with friends, family and school mates.
 
On Dec. 12, Tech police received a report of Cho's harrassing behavior towards another female student. After police confronted him, Cho sent an instant message to one of his roommates saying he should just kill himself because "everybody hates me." The roommate called Tech police, who brought him to the department headquarters and called Kathy Godbey from the New River Valley Community Services Board.

Cho brushed off his odd behavior in conversations with Godbey, an Access counselor, and claimed his suicide threat was a joke. According to the Virginia Tech Review Panel report issued in 2007, Godbey interviewed police and two of Cho's roommates and determined from their reports of bizarre behavior that he was mentally ill and an imminent danger to himself or others.
 
Cho was "unable to come with a safety plan to adequately ensure safety. [Client] unwilling to contact parents to pick him up although he understood this was the only other option beyond [temporary detention order]," Godbey wrote.

Cho was hospitalized that night at Carilion St. Alban's Behavioral Health. The following day Dr. Jasdeep "Bobby" Miglani evaluated Cho. He recorded that Cho denied any history of mental illness and again claimed his suicide threat was a joke. "Some outpatient counseling" is recommended and "Access will also do some safety checks," the report stated.
 
Diagnoses were listed as "acculturation issues" and "stress of college life." His suicide threat was deemed "more an act of frustration" than a cause for worry.
 
However, according to the panel report, at a commitment hearing held later that day, a special justice ruled that Cho "presents and imminent danger to himself as a result of mental illness" and ordered outpatient treatment.
 
At 3 p.m. that day, Cho was triaged for the final time by Cook center counselor Sherry Lynch Conrad. In that 30-minute session, Cho tells Conrad he has "no reason to kill himself and never would." Cho tells her he has one more final exam to take before the winter break and that his hospitalization did not put him behind in his schoolwork.
 
Conrad encourages Cho to return to the center for counseling in January, but she "did not schedule an [appointment] because he doesn't know schedule." The counselor provided several emergency phone numbers to Cho and encouraged him to call "if he begins to have suicidal or homicidal thoughts."
 
Miglani's summary medical discharge report is sent to Cook staff in January, according to the Virginia Tech panel report. Former Cook Counseling Center Director Robert Miller, who turned in the missing records last month to Tech officials, was demoted in February. As he cleaned out his desk, Miller has said he mistakenly took Cho's records and those of a handful of other students with him. The Cook center has no further contact with Cho.
 
It's unclear if Access counselors conducted the recommended safety checks.
 
Cho's problems with classmates and English professors escalated in 2006, according to the panel report and university e-mails.
 
On April 16, 2007, Cho killed 32 students and faculty, injured dozens more and then shot himself.