Mental problems are definitely a factor, the driving factor most likely. Those with psychological and social problems are much easier to radicalize than those without. The mass shooter profile is often an unmarried, unemployed or underemployed, male in his late teens to early 30s who is bitter at the world. Before the Internet/Cable news, this type would just off themselves, going out with the proverbial "whimper." Columbine coincided with the rise of the 24/7 cable news cycle and broke the mold. Now depressed, disgruntled individuals found a way to get back at the world and leave it with the proverbial "bang." A mass shooting allows them a sense of power, control, and notoriety they've never had in their lives before they die or get captured.
I believe many of these mass shooters really don't care about a "cause." They just want to wreak havoc for havoc's sake, but if they pen some asinine manifesto beforehand, they know they'll receive more infamy. The Internet plays a huge role here in spreading that infamy faster than even before, especially with the proliferation and ubiquity of social media. The mass shooter plans his act knowing full well he'll be the center of attention for a week or more. In the past (pre-cable news), if there was a mass shooting, a brief report would show up on your local 11 o'clock news and they would move on to the next story. Now these events are incessantly covered. And holes like the Chans, et al have exalted these psychos as anti-heroes.
I've always said a solution to this epidemic is going to require a multifaceted approach that enacts reasonable gun control (i.e. age limits, stricter licensing procedures, etc), improvement in mental health care, and probably most importantly, a fundamental change in America's collective cultural mentality. It's ingrained into us at a very early age that if you're not wealthy, talented, and attractive, you're essentially a worthless piece of . It's not surprising the vast majority of these shooters are single "incel" types without much going for them in those 3 areas.
I don't say this to laugh at them, but to illustrate what Americans place value on. If we "value" other things besides money, sex, and "talent," maybe these incels would find positive things worth living for. As it stands, they reflect on their lives that lack wealth, a sex life, and career opportunity, and basically say " it," because again, we're taught those are the only things in life that matter.

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