When police killed Miriam Carey after a car chase that ended at the U.S. Capitol, it reignited a debate over how to prevent such tragedies.
But this time, the conversation was not about guns (Carey was unarmed). It was over access to mental-health care; and some say Obamacare, unpopular as it is, may help.
"After each one of these tragedies, everyone talks about improving mental-health services in America," said Sen. Debbie Stabenow, D-Mich. "It's time to finally take action to do that."
Lack of insurance and the high cost of care are the biggest reasons mental-health patients don't seek treatment, according to a study released in this month's Health Affairs.
The Affordable Care Act supports increased access to mental-health services, with insurance coverage through the law's exchanges set to begin Jan. 1 for those who sign up by Dec. 15. The full implementation of the ACA, according to a Health and Human Services report, will provide first-time access to mental-health services for roughly 32.1 million Americans.
The new health law requires all insurance plans in the exchanges and in the individual and small-group markets to treat mental-health services equal with other forms of care when it comes to co-pays and deductibles. In the past, insurance companies did not cover — or required higher out-of-pocket costs for — mental-health services. Stabenow proposed the parity amendment, which is now part of the ACA.
"People with mental illnesses are more likely to have lower incomes," said Kathleen Rowan, a doctoral student at the University of Minnesota and the primary author of the study published in Health Affairs. "That's because mental illness might be limiting in terms of the work they are able to do or the hours they are able to work. And so, many people face cost barriers in terms of access to care."
The law will open the doors to affordable care for many of these individuals, Rowan said, through the subsidies on the exchanges and the expansion of Medicaid.
Stabenow's communications director, Cullen Schwarz, said that had the Navy Yard shooter had access to treatment, the outcome could have been different. He cites studies showing that people who go without treatment are more likely to commit acts of violence.
"It's not that we'll always stop these tragedies from happening," Schwarz said, "but we can certainly strengthen mental-health services and reduce the number."
The next obstacle, Rowan said, will be whether the scope of services and the number of doctors are able to meet the increased demand for mental-health care.
"You know what our biggest provider of mental-health services is?" asked Dr. Eliot Sorel, a clinical professor of psychiatry and behavioral sciences at the George Washington School of Medicine and Health Sciences. "U.S. jails and prisons. That's the result of us not attending to this need."