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."

Other contributing factors in the rankings were a state's percentage of residents who say they can't afford health care, prevalence of serious depression and suicide rate.

Payne said the report does not conclude nor suggest that lack of care causes depression or suicide. But depression rates can be reduced by improving insurance coverage and parity, making sure qualified professionals are available and educating the public about depression, he said.

The study also notes that the depression status of states is likely to decline in general over the next decade because the number of trained mental health professionals and federal funds to help train them are in dramatic decline.

The full "Ranking America's Mental Health: An Analysis of Depression Across the States" is available at www.mentalhealthamerica.net.

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E-mail: jthalman@desnews.com