Arcan Cetin did not fall through the cracks.

Cetin’s struggle with mental-health problems are well documented, as are the efforts made by the law-and-justice system, treatment providers and his family to get him help, court documents and mental-health records show.

Authorities haven’t said what the 20-year-old Oak Harbor man’s motives might have been for allegedly shooting five strangers to death in the Cascade Mall in Burlington Sept. 23, but mental-health issues will almost certainly be an important element in the case.

The records suggest that Cetin’s problems were complex and deep-seated.

Cetin’s mother had him out of wedlock in Turkey, which socially stigmatized them both, according to an email a defense attorney sent to a prosecutor last year. Cetin witnessed his mother being beaten by her father and brothers daily; he was also abused by the men, who even chased him with knives.

Cetin suffered from an injury at birth that affects his ability to move an arm and caused one arm to be significantly shorter than the other. He was run over by a bus when he was 6 years old, which broke his pelvis and left him unable to walk for months. He suffered kidney failure. He is extremely socially awkward, the attorney wrote.

“Arcan has yet to complete high school and still has an entire life ahead of him,” attorney Brent Thompson wrote last year. “I believe he is intelligent and very bright, but is struggling psychologically.”

Cetin has been diagnosed with or was suspected of suffering from at least 13 different disorders, including post traumatic stress disorder, attention-deficit disorder, autism, depression, fetal alcohol syndrome, intermittent explosive disorder, disruptive disorder, and several substance-abuse disorders, according to mental-health records.

Reports state that Cetin’s “drug of choice” was alcohol and that he also used marijuana on a regular basis. In fact, court documents state that he smoked pot prior to each of three assaults he was charged with committing in Oak Harbor.

Cetin has seen at least four mental-health treatment providers in his life and was involuntarily committed to a psychiatric hospital last November after a suicide attempt. He was on three different psychiatric drugs — Prozac, Concerta and guanfacine — as of 2015.

Cetin is being held in Skagit County on suspicion of five counts of first-degree murder. He has not been charged.

Cetin’s prior criminal history consists of three main cases, all of which are gross misdemeanor assaults.

In one case, Cetin went looking for his stepfather’s guns and had to be restrained; he’s accused of using a gun he stole from his stepfather in the Cascade Mall shooting.

Police were called to domestic assault at the family home in Oak Harbor on Oct. 28, 2014. His parents told the officer that Cetin was upset that his girlfriend was moving away and had been acting disrespectful for days. That night he broke a glass door on an entertainment center and punched holes in walls. He grabbed his mother’s hand and started striking himself in the face with it, according to the police report.

Cetin overheard his stepfather tell dispatchers that he had guns under his bed. The young man went straight to the bedroom and started looking under the bed. His stepfather grabbed him and pinned him against a wall until the police arrived.

The police arrested Cetin on suspicion of fourth-degree assault and malicious mischief.

In another case, Cetin was accused of assaulting two girls at Oak Harbor High School May 27, 2015. He was accused of rubbing his feet up their legs and inner thighs during a math class. He allegedly was leering at them and continued running his feet on them even after the girls repeatedly told him to stop. He took his shoes off and tried to push them between one of the girl’s legs, the police report states.

When asked by police about the incident, Cetin at first said he wasn’t at school that day and then said things that didn’t make sense, the officer wrote.

Cetin was arrested on suspicion of two counts of fourth-degree assault with sexual motivation.

On June 19, 2015, Cetin and his stepfather got into an argument over pot smoking. During the argument, Cetin leaned towards his stepfather and kissed him on the lips. His stepfather told him not to, but Cetin again kissed him. When his stepfather put a hand on Cetin’s chest to stop him, Cetin struck him in the face twice, the police reports state.

Five months later, records show, Cetin allegedly tried to kill himself by overdosing on his medication. A psychiatric ARNP from Fairfax Hospital in Kirkland petitioned to have Cetin involuntarily committed and treated for 14 days, based on his “likelihood of self harm” and the fact that he was “gravely disabled as a result of a mental disorder.”

The three cases against him were combined for a “global resolution” in which he was granted deferred prosecution on the basis of mental-health problems. The charges would have been dismissed, but would remain on his record, if he complied with treatment that consisted of weekly medication monitoring, one substance-abuse class a week, two sober support groups a week and monthly meetings with a substance-abuse-prevention counselor, the report states.

Records show that he was complying, though he wasn’t happy about having to travel to Skagit County for some of the treatment.

In addition, court documents state that he was under the care of a psychiatrist in Oak Harbor.

The records also make it clear that Cetin received mental health evaluations and at least some treatment — including ADHD medication — at an early age, years before his arrests.

Cetin worked at various places on Whidbey Island during and after high school. He was a dishwasher at a buffet restaurant, worked at an auto repair business, was a bagger at the Navy commissary and worked at Wendy’s restaurant at Naval Air Station Whidbey Island. He was interested in becoming an anesthesiologist.

A report in January of this year from the Follman Agency in Skagit County states that Cetin had stopped using marijuana, his mental-health and substance-abuse problems were moderate and his prognosis was fair.

In March, a social worker wrote that Cetin’s psychiatrist wanted him to have “a neuropsychology exam and be evaluated for autism spectrum disorder among other things.” One of his short-term goals was to “verbalize an understanding of the relationship between repressed angry and depressed mood.”

His long-term goal in treatment was to “establish the ability to effectively channel impulses,” the report states.