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Mental Health America, a non-profit,  ranked all 50 states and the District of Columbia by various measures of mental illness. Their investigation confirms that a staggering number of Americans are afflicted by some kind of mental illness. Some 20 percent of Americans have a mental health problem — that’s nearly 45 million people. According to the same report only half receive treatment for their illness.

Overall, the top three states with the lowest prevalence of mental illness, but also the best access to care, were New England: Connecticut, Massachusetts, and Vermont. Oppositely, the authors of the report ranked the worst states as Oregon, Arizona, and Nevada.

Of the ten worst states to be mentally ill, six of them also rank high for having the highest incarceration rate.  In Arkansas, Mississippi and Alabama, 57,000 men and women who are behind bars suffer from some kind of mental illness.

“Once again, our report shows that too many Americans are suffering and far too many are not receiving the treatment they need to live healthy and productive lives,” Paul Gionfriddo, president of Mental Health America, said in a statement. “We must improve access to care and treatments, and we need to put a premium on early identification and early intervention for everyone with mental health concerns.”

“It’s time to act,” Gionfriddo added. “We must invest in the overall physical and mental well-being of our citizens — every day.”

Most of these people who are classed with some mental health problem are insured but still do not receive treatment, either because they did no seek it or because they do not trust care in their region. Gionfriddo says that in light of these worrisome findings, every state should make facilitating mental health treatment a priority. Facilities need to be improved, staff trained, and the public needs to be made aware that they might be mentally ill and require assistance.