Thailand has a vibrant medical system, particularly for an upper-middle income nation. But that strength does not extend to mental health services. A string of mass shootings committed by security personnel in recent years has highlighted concerns about the psychological fitness of members of the military and the police, who must hew to strict hierarchies and endure low pay.
Panya Kamrab, 34, who was identified by the Royal Thai Police as the gunman in the mass shooting at the day care center in northeastern Thailand on Thursday, was an officer in the force until he was dismissed in June for drug possession.
A mere 2.3 percent of Thailand’s health expenditures are allocated for mental health, according to the World Health Organization. Thailand, with a population of about 70 million, had only 656 psychiatrists and 422 psychologists in the entire country, according to the W.H.O.’s Mental Health Atlas 2020. The Royal Thai Police alone has roughly 220,000 officers.
Mr. Panya was set to go on trial on Friday, and the 9-millimeter pistol used in the attack was legally owned, the police said.
“He abused drugs and was very stressed and upset about his career, his position, his status,” said Kritsanapong Phutrakul, the chair of the faculty of criminology and justice administration at Rangsit University and a police lieutenant colonel. “To reduce the risk to Thai society, his gun should have been taken away from him when he was fired.”
Military-style hierarchies are imposed on many facets of Thai society, from schools to offices. The chains of command can leave lower rank-and-file people with little recourse if they disagree with superiors’ orders.
Outside the security forces themselves, the military’s influence is profound. Prayuth Chan-ocha, the prime minister of Thailand, is a former army chief who took power in a coup. His deputy is also a former army chief.
And the nation is trained to pay obeisance to the Thai royal family. Courtiers crawl along the floor in a submissive pose in front of senior royals. A notoriously tough lèse-majesté law makes it a crime to defame senior members of the monarchy, and a long list of people have been jailed for such offenses.
Dissatisfaction with institutional strictures prompted students to protest in recent years, at first demanding an easing of rules on hairstyles and dress. The rallies expanded to encompass calls for reforms to the government and the monarchy.
The perils of such a rigid society may have helped catalyze what, until Thursday, had been the deadliest mass shooting by a single perpetrator in Thai history. Two years ago, Sgt. Major Jakrapanth Thomma went on a killing spree at a shopping mall and army base, killing 29 people and wounding 58 others. He was angered by a financial dispute with the family of his superior officer, according to the country’s then army chief. Members of that family refused to pay him money he was owed, he told friends. He had run out of options, he told them.
The soldier was shot dead by the authorities, ending the attack. But questions lingered about why he had targeted civilians at a shopping mall after killing people on a military base.
Last month, a police lieutenant general opened fire in a military school in Bangkok, killing two people.
“From a security risk perspective, we have to better check the mental health of people who own guns,” said Lieutenant Colonel Kritsanapong.