WASHINGTON, D.C. — Aside from the infectious disease nature of COVID-19, there is also a mental strain the virus is placing on people the world over.

Depression is at the top of the list.

“People took a depression screening to get a sense about how they were being impacted by the pandemic,” said Paul Gionfriddo, president of Mental Health America (MHA).

MHA is a nonprofit that provided mental health screening for more than 2.5 million people all across the country in 2020. Then, they analyzed the data collected.

“We looked at suicidal thinking and self-harm thinking and discovered that 38% of the people who had taken a screening indicated that they had suicidal or self-harm thinking on more than half the days of the week,” Gionfriddo said.

Because of the sheer number of people who participated in the screening, Mental Health America was able to delve into the numbers by location.

Their findings showed the states with the highest number of people with thoughts of suicide were California, Texas, and Florida.

Those findings were not necessarily surprising, considering their large populations.

However, when they looked at the highest percentage of the population contemplating suicide, less populated, more rural states, Alaska, Wyoming, and Alabama jumped to the top spots.

“All the changes, all this destructive disruptions to their lives have had an effect, and we can't overlook this,” Gionfriddo said.

The findings went deeper, to county-by-county levels.

The study found those with the highest percentage of people contemplating suicide included large counties, including Bexar County, Texas, where San Antonio is; Clark County, Nevada, where Las Vegas is; and Riverside County, California, east of Los Angeles.

It also included smaller counties, like Carroll and Whitley counties in Kentucky and Switzerland County, Indiana.

“Even in these small counties that may not have the wherewithal or get the attention, there is a very deep-seated need in even those counties,” said Ann Hartry, a vice president with the pharmaceutical company Lundbeck, which helped fund the independently conducted MHA study. “When I saw these numbers, they are daunting. They are scary. But I think it's a really important view of reality that we gain so that we can actually start to step up and step into it and find even more to do about it.”

That includes using $130 billion in available federal stimulus money, among other funding, for local solutions.

“Then, you have the opportunity in a local area or in a state area to use some of these new block grant dollars that are coming from the federal government,” Gionfriddo said. “We can build a system for everybody, that would serve the needs of everybody, at the earliest possible stages.”

An average of 45,000 people die by suicide in the U.S. every year. If you or someone you know is in need of help, call the National Suicide Prevention Lifeline at 1-800-273-8255 or click here to go to their website.