Non-profit organization Mental Health America has released its third annual report on Americans’ mental health, and the results are not good: more than 40 million Americans, which is 20 percent of U.S. adults, experience some kind of mental health concern. And more than half of the adults have a mental health issue don’t receive any treatment for it, even when it affects their ability to function on a day to day basis.

The report covers all 50 states and the District of Columbia, and it found that 1.2 million people who have a mental health problem are in prison and don’t have access to the health care they need, according to a statement from the organization. Depression is one major health issue that affects a huge amount of young people, increasing from 8.5 percent of youth in 2011 to 11.1 percent in 2014. And about 60 percent of people who suffer from depression don’t get treatment.

Mental Health America says we have a tremendous shortage of mental health professionals, which could be a contributing factor in this rise in mental health issues. It estimates there is only 1 mental health professional per 1,000 individuals in states with the lowest numbers of them, despite the fact that demand for them is growing.

“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 and CEO, Mental Health America. “Mental illness touches everyone. 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.”

“This is ultimately about policy decisions we make. It isn’t just about what states are red and what states are blue,” Gionfriddo added, “because there are some of each near the top and the bottom. But political environments in states do seem to matter. Those that invest more in mental health clearly have to throw away less money on jails and prisons.