In 2013, The U.S. Substance Abuse and Mental Health Services Administration (SAMSHA) released its annual report on drug use and mental health disorders in America, and its findings confirm: Americans cannot afford the cost of their mental health treatment — even if they have insurance.

The report estimated that 45.6 million American adults suffered from Any Mental Illness (AMI) in 2011, comprising 19.6 percent of the adult population. Of that 45.6 million, a meager 38.2 percent received any sort of mental health services.

While 15 percent of Americans suffering from AMI cited inadequate insurance coverage as their main obstacle to seeking care, a staggering 50 percent said that mental health treatment costs are simply too high. And that number includes both insured and uninsured Americans, illustrating how expensive out-of-pocket costs for mental health care are relative to the available coverage.

The data also highlights the damage done by the cultural stigma associated with such care. Over 37 percent of Americans who should have received treatment didn’t believe that they needed any or that treatment wouldn’t help — a dangerous assumption that is likely to exacerbate mental illness — and an additional 35 percent were afraid of negative social consequences or being institutionalized.