(CNN) -- The nation does a poor job in the ways it serves its mentally ill population, earning a D, according to a report card issued Wednesday by an advocacy group.
Three years ago, the National Alliance on Mental Illness (NAMI) gave the United States a D for its mental health care system for adults. The new report, it said, shows only marginal progress -- not enough to warrant a better grade.
Additionally, a "major dark shadow" looms as downturn-forced state budget cuts are threatening such care, according to NAMI.
"Ironically, state budget cuts occur during a time of economic crisis, when mental health services are needed even more urgently than before," NAMI's executive director Michael Fitzpatrick said in a statement. "It is a vicious cycle that can lead to ruin."
Fourteen states improved their grade since the last report card, with Oklahoma climbing from a D to a B. View states' grades from NAMI
Twelve states fell backward. South Carolina fared the worst, going from a B to a D.
NAMI is the nation's largest grassroots organization. According to the group, one in four Americans experience mental illness at some point in their lives, and it is the greatest cause of disability in the nation.
All About Mental Health