The number of people living with mental illness is on the rise across the United States. But even more disturbing are recent findings from an annual nationwide review of psychiatric services by Mental Health America that shows there’s a lack of mental health providers, costs are escalating for psychiatric care, and not enough states invest in mental health programs—which are all major barriers to care in this country, The Washington Post reports.

For the study, researchers at Mental Health America, a national community-based nonprofit organization, ranked all 50 states on 15 measures. These metrics included adults with any mental illness, young people with at least one major episode of depression in the past year and the availability of mental health workers.

Overall, findings showed that almost 44 million adults in the United States are living with mental illness. The report also found that 56 percent of those individuals didn’t receive any treatment in the past year. In addition, scientists noted that access to mental health care is only “slowly rising,” even with major insurance coverage expansions under the Affordable Care Act that went into effect in 2014. 

“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,” said Paul Gionfriddo, president of Mental Health America, 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.” 

Advocates also stressed that there’s a widespread failure among many Americans to recognize or acknowledge symptoms of mental illness when they occur.

Additionally, untreated mental illness can carry a wide range of personal and societal costs, such as a loss of productivity and income, higher rates of incarceration and an increased risk of other serious health issues, such as HIV/AIDS, viral hepatitis, heart disease and stroke.

Click here to learn more about how depression, anxiety and other mental illness can affect your physical health.