Mental Health America released its 2019 “State of Mental Health” report and rankings Wednesday. Nevada placed 51st — behind every other state and the District of Columbia.

Nevada ranked 51st in last year’s report.

And in the previous year.

Mental Health America uses 15 different measures for its rankings. They include prevalence of mental health issues and episodes among adults and youth, as well as access to and insurance coverage for mental health services. A high overall ranking indicates lower prevalence of mental illness and higher rates of access to care. A low overall ranking indicates higher prevalence of mental health illness and lower rates of access to care.

Nevada performed poorly in the majority of the report’s measures. Among the most troubling findings: Nevada had the highest percentage of youth coping with severe major depression: 12.7 percent. The national average was 8.7 percent.

Nevada also had the second highest percentage of adults with a mental illness who receive no treatment: 63 percent. Only Hawaii had a larger percentage. The national average was 56.4 percent.

Nevada ranked 48th for adult mental health and 51st for youth mental health.

Silver State residents in search of better access to mental health care might want to move north and east. Minnesota, Maine, Massachusetts, New Jersey and Vermont were the top five states for mental health. Joining Nevada at the bottom of the list are Idaho, Oregon, Mississippi and Alaska.

The complete report and full rankings are available here.