"Hate is not a rural or urban thing, it's not a midwestern thing," said Dr. Peter Jaberg, a licensed psychologist at Forest Institute.
He said its difficult to pinpoint a single cause for hate-driven crimes.
"Sometimes it can be associated with a psychotic disorder," said Dr. Jaberg. "There are some cases where individuals might not be psychotic and they have perhaps lost hope in other goals or aspects in their life-- that their life has meaning in these acts."
White supremacist Frazier Glenn Cross is accused of going on a killing spree Sunday afternoon at Jewish facilities near Kansas City. According to the Southern Poverty Law Center, there are 939 hate groups operating across the country, 23 of which are active organizations here in Missouri. But many people are wondering why Cross would commit the killing.
"I think all of us were surprised to see Miller at age 73 engage in mass murder," said Mark Potok, a senior fellow at the Southern Poverty Law Center.
Potok said the organization has kept a close eye on cross.
"There really was nothing in what he wrote in months leading up to this that indicated a real escalation," he said.
Dr. Jaberg says cultural influences affect people's behavior, and develop over time. But there is one thing you can look for that may be a cause for concern.
"A change in behavior," said Dr. Jaberg. "So a change in routines, stuff that might seem really boring, the mundane stuff."
A change in behavior may not necessarily lead to malicious intent, but Dr. Jaberg said its important to take these signals seriously.
"I think if we were all more attentive in those situations, we're going to catch a lot of people who aren't about to go on a killing spree, but we're also catch people who really need help," he said.
If you or someone you know may be experiencing mental health issues, local resources you can reach out to include the Southwest Missouri National Alliance on Mental Illness and Burrell Behavioral Health.
You can also search "mental health" on the Centers For Disease Control and Prevention and World Health Organization websites for additional online resources.