TEXAS — Texas may lead the pack when it comes to business and gas and oil production, but it falls short in providing critical mental health care resources to its residents.

That’s the finding from Forbes Advisor, which for the second year has ranked Texas the worst state for mental health care.

Texas may be at the bottom, but the survey shows mental health treatment is sorely lacking cross the country.

Forbes said that one in five Americans deals with a mental health condition each year, and 76% of Americans are dissatisfied with the state of mental health treatment in the U.S.

Forbes, citing Mental Health America data, further said that more than half (54%) of adults with mental illness do not receive any treatment at all. That’s roughly 28 million people. More than one in four do not receive adequate treatment.

What contributes to the lack of care? According to Forbes, the main issues are lack of health insurance, too few treatment centers and high costs.

It’s well known that Texas has the highest number of uninsured residents in the country. Forbes said Texas has the second highest number of uninsured adults with mental illness.

In addition, according to the study, Texas also has the second highest percentage of youth with depression who do not receive mental health services. Many of those minors have private health insurance that does not cover health issues related to mental or emotional problems.

About one-third of adult Texans with a mental health disorder cannot see a doctor because of cost, the study shows.

Texas has the third fewest mental health treatment centers, 8.4 per 10,000 businesses. More than half of adult Texans with mental illness do not receive any treatment at all (62.3%).

Georgia, Alabama and Florida fared slightly better than Texas in the ranking.

The best state for mental health care, according to Forbes, is Vermont.