Pamela Cisneros’ Brother Reveals Years of Mental-Health Struggles as Family Searches for Answers After Times Square Attack
SHE SAID SHE WAS “FINE” — THEN, JUST DAYS LATER, EVERYTHING CHANGED.
Pamela Cisneros’ brother says his sister had struggled for years, but had recently found stability through treatment and showed no signs of aggression or violence.
So what happened between that seemingly normal weekend and the terrifying scenes in Times Square? Her family says they are still desperately searching for an answer — and one detail about the days before the incident is raising even more questions. 👇
The full story is here — and the timeline is hard to ignore.
Pamela Cisneros’ Brother Reveals Years of Mental-Health Struggles as Family Searches for Answers After Times Square Attack
Pamela Cisneros’ family is struggling to understand how a woman they say had never displayed violent behavior could become involved in a terrifying Times Square attack that left a 32-year-old Bank of America executive dead.
Cisneros, 49, was fatally shot by NYPD officers on Aug. 31 after police said she attacked two people with knives in the heart of Manhattan. The first victim, 68-year-old Tak Kam, survived. The second, Erin Piacenti, a Bank of America vice president and new mother, died from her injuries.
In the days since, details about Cisneros’ personal life and longstanding mental-health struggles have emerged through interviews with her relatives.
Her brother, Patrick Peralta, told the New York Post that Cisneros had struggled with mental-health problems for years and that he believed she may have been diagnosed with bipolar disorder.
Yet, according to Peralta, there had been no obvious indication that she was about to become violent.
“She never showed any aggressiveness or being violent. I don’t know what happened,” Peralta told The Post.
The apparent disconnect between Cisneros’ family history and the events in Times Square has become one of the central questions surrounding the case.
A Family Says She Had Been Doing Better
Peralta described his sister as someone who had experienced serious personal difficulties but had achieved a degree of stability through treatment.
He told the Post that Cisneros had been receiving medication in recent years and appeared to be doing relatively well.
As recently as Saturday, according to Peralta, she had told relatives that she was “fine.”
Her father, Mario Cisneros, separately told ABC7 New York that his daughter had been receiving monthly medication injections for a mental-health condition. He said he had seen her approximately a week before the Times Square incident and that she appeared to be doing well.
“I knew my daughter very well but I didn’t know what was going on with her,” her father said, while describing the injections she had been receiving. (abc7ny.com)
Those comments have raised questions about whether there was a change in Cisneros’ treatment or mental state before the attack.
But neither her family nor authorities have established that a medication change triggered what happened.
Peralta reportedly speculated that she may have stopped receiving her injections, but that remains an unconfirmed family theory rather than an established fact.
A Troubled History
Cisneros’ mental-health difficulties reportedly stretched back years.
Her family has described postpartum depression following the birth of her second child and a later possible bipolar diagnosis.
According to the New York Post, Peralta also described a previous suicide attempt and other episodes that brought Cisneros into contact with authorities.
Police Commissioner Jessica Tisch has said Cisneros had previous encounters with the NYPD connected to mental-health concerns, including incidents in 2018 and 2019.
However, she had no prior arrest record, according to authorities.
That distinction has become important as investigators attempt to understand her background.
A history of mental-health problems does not establish why a person commits a particular act, and there is currently no public evidence demonstrating that Cisneros’ diagnosis directly caused the Times Square attack.
Instead, the history provides context for a family trying to understand a sudden and devastating event.
The Mother of Three
Cisneros was also a mother of three daughters.
According to family members, her children were in their late teens through late 20s.
Her relationship with some of them had reportedly become strained over the years.
The family has said her eldest and youngest daughters had been living in Florida with their father and were estranged from Cisneros for several years.
Her middle daughter is nonverbal and has severe autism and lives at a care facility in Brooklyn.
The family circumstances add another layer to the portrait emerging of Cisneros — one involving divorce, separation from her children and longstanding personal difficulties.
Yet relatives have emphasized that these struggles did not necessarily translate into aggressive behavior.
Peralta’s statement that he had never seen his sister act violently is particularly striking given what happened in Times Square.
What Happened in Times Square?
The attack unfolded during the busy afternoon of Aug. 31.
Police said Cisneros was carrying two large knives when she allegedly attacked a 68-year-old man near West 41st Street and Seventh Avenue.
She then moved toward another area of Times Square and attacked Piacenti.
Piacenti, 32, was transported to Bellevue Hospital but died from her injuries.
Cisneros then encountered police officers.
Authorities said officers repeatedly ordered her to drop the knives.
She refused.
According to Police Commissioner Jessica Tisch, Cisneros threatened officers while continuing to hold the blades.
Officers attempted to use Tasers to stop her, but the devices were reportedly ineffective.
Cisneros then moved toward the officers, prompting two officers to fire their service weapons.
She was taken to Bellevue Hospital, where she was pronounced dead.
The New York Attorney General’s Office of Special Investigation has since opened an investigation into the police shooting. (ag.ny.gov)
The Family’s Confusion
For Cisneros’ relatives, the most difficult part may be reconciling the person they knew with the woman seen in videos from Times Square.
Her father said she had appeared normal when he saw her shortly before the attack.
Her brother likewise said there had been no obvious warning signs.
That does not mean there were no warning signs at all.
Police have acknowledged previous mental-health-related encounters, and relatives have described years of difficulties.
But the family says nothing they observed recently suggested that Cisneros was preparing to harm strangers.
That uncertainty has left them searching for an explanation that may not yet exist.
Erin Piacenti’s Family Faces a Different Loss
While attention has focused heavily on Cisneros, the case began with the loss of another family member.
Erin Piacenti was 32 years old and worked as a vice president at Bank of America.
She was also a new mother.
According to People, Piacenti had returned to work on Aug. 31 after maternity leave. She had a 5-month-old daughter and had recently moved with her husband, Frank, to Chester, New Jersey. (people.com)
She was heading home when she became one of two victims in the apparently random attack.
The contrast has made the case particularly heartbreaking.
One family is mourning a young mother whose life was abruptly taken.
Another family is trying to understand how their own daughter and sister became involved in the incident.
Online Debate Centers on Mental Health
The disclosures about Cisneros have generated significant discussion online.
On Reddit and other social platforms, users have debated whether her reported mental-health history should be viewed as an important warning sign or simply as background that should not be used to explain the attack without evidence.
Some commenters have focused on the question of whether people experiencing severe mental-health crises can receive effective intervention before a situation becomes dangerous.
Others have cautioned against associating mental illness broadly with violence.
That distinction is important.
Most people living with mental-health conditions are not violent. A diagnosis alone cannot establish motive, intent or responsibility in an individual case.
In Cisneros’ case, investigators still have to determine what happened immediately before the attacks, whether there was a specific trigger and whether any change in her circumstances played a role.
A Digital Trail May Offer More Clues
Another potentially important part of the investigation is Cisneros’ online activity.
Reports have emerged about social-media posts that appeared increasingly focused on religion, societal collapse and violence in the months preceding the attack.
The Sun reported that Cisneros had made a disturbing post in 2025 referencing people being harmed “for no reason.” However, the significance and context of such posts have not been established by investigators publicly. (thesun.co.uk)
That makes the digital evidence potentially relevant but far from conclusive.
Social-media posts can be interpreted in multiple ways, especially when viewed after a tragedy.
Investigators will need to determine when posts were made, what Cisneros intended them to mean and whether they corresponded to an actual change in her behavior.
The Questions Investigators Still Need to Answer
Several major questions remain unresolved.
Why did Cisneros allegedly target two strangers?
What happened in the hours before the attacks?
Had there been a recent change in her treatment?
Did she stop receiving medication?
Was there a specific personal or psychological trigger?
And was there anything in her behavior before the attack that relatives or authorities could reasonably have recognized as a warning sign?
None of those questions currently has a definitive public answer.
Peralta’s comments provide an important family perspective, but his suggestion that Cisneros may have stopped treatment has not been confirmed by authorities.
Similarly, her reported bipolar diagnosis should not automatically be treated as an explanation for the attack.
The Police Shooting Will Face Separate Scrutiny
The circumstances of Cisneros’ death are now being examined independently from the attacks themselves.
The Attorney General’s Office of Special Investigation has opened a case into the police shooting.
Investigators are expected to examine body-camera footage, cellphone videos, witness statements, police communications and forensic evidence.
That review will help establish precisely what happened during the confrontation and whether officers followed the applicable rules when they used deadly force.
Videos already circulating online show officers attempting to stop Cisneros before the encounter ended with gunfire.
But short clips can leave out critical context.
The investigation will therefore be important in establishing a complete timeline rather than relying on individual pieces of footage shared across social media.
A Family Still Looking for an Explanation
For now, the picture emerging of Pamela Cisneros is complicated.
She was a mother of three who reportedly struggled with mental-health problems for years.
Her family says she had experienced difficult periods, including postpartum depression, family separation and other personal crises.
Yet relatives also say that she had found some stability through treatment and that they saw no obvious indication that she was about to become violent.
Then came the events in Times Square.
Two strangers were attacked.
One survived.
Piacenti, a 32-year-old new mother returning to work, did not.
Cisneros was subsequently confronted by police and died after officers opened fire.
The tragedy has now generated questions about mental-health intervention, public safety, police response and the difficulty of recognizing when someone in crisis may be deteriorating.
But the most important question remains unanswered: what changed for Pamela Cisneros between the woman her family believed was doing “fine” on Saturday and the terrifying events that unfolded two days later?
That answer, if investigators can establish it, could provide the missing piece in understanding a tragedy that has left two families dealing with entirely different forms of loss.
