Utah is the most depressed state in the country, according to a nationwide study released Wednesday.

The first-of-its kind examination of the "level" of depression and actual outcomes for those seeking help to treat it, ranks Utah 51st — last in the nation.

Hawaii, Illinois, Maryland and New Jersey are the healthiest states in terms of depression and suicide. Along with Utah, Idaho, Nevada, Wyoming and West Virginia are the least, according to the study.

Other states have a higher suicide rate — Alaska has the highest; Nevada the second — but the four factors combined in the study places Utah last on the list.

A spokesman for Mental Health America said the study isn't meant to point fingers at any state in particular but to highlight the country's major need for mental health resources, preventative treatment and federal legislation that would make mental health services as important as treatment for physical problems on medical insurance plans.

The study was conducted by Mental Health America, formerly known as the National Mental Health Association. It is the country's largest nonprofit mental health advocacy group and has 320 affiliates nationwide. Research was underwritten by a grant from Wyeth Pharmaceuticals, one of the largest drug manufacturing companies in the world.

"No matter the funding source nor the categories used, depression has a serious effect on the well-being of individuals and the population as a whole," said Mark Payne, director of the Utah Division of Substance Abuse and Mental Health. "Depression in Utah is a legitimate and ongoing concern across the state," he said, noting that $2.7 million in state funding approved by the Legislature is being used to determine the most helpful services to people suffering from depression.

Payne and the authors of the study said one of the biggest factors in Utah's ranking is lack of access to mental health services, due in large part to a lack of or minimal coverage for mental health services on most employer-provided insurance plans.

The study noted that achieving parity with other medical services would improve both the home and the workplace. People who are depressed miss more work, are less productive at work and are less involved in school and at home than those who aren't depressed.

Payne said the study might be oversimplified because states have so many variables in population characteristics, location and approaches to treating depression.

Other studies have shown that the West tends to have more depression and suicide because people are more isolated and thereby more at risk for depression.

Despite the variables among the states, the lack of access to help is a key contributing factor in the rankings, said David Shern, president and CEO of Mental Health America. "States can and do significantly improve their populations' mental health status by adopting policies that expand access to treatment."