I've seen over 20 escorts since I started hiring four years ago and only two had recognizable "issues". The first was a cutter and the second you could just sense there was something off about him. He died a year or two after we met and I wouldn't be surprised if it was suicide or an overdose.
In contrast, the vast majority of escorts I've seen are guys with their act together who just simply like the money and attention they get from clients. A number of them travel internationally throughout the year and have instagram accounts with large followings, and enjoy the lifestyle that escorting allows them to afford. These are not guys who are "messed up in the head," quite the opposite.