Mental healthcare services continue to feel the pinch of strained state budgets, as a new study shows states cut more than $1.6 billion in general funds from their state mental health agency budgets from fiscal years 2009 through 2012.

The findings from the National Alliance on Mental Illness, or NAMI, reported that South Carolina (39.3%) Alabama (36%), Alaska (32.6%), Illinois (31.7%), Nevada (28.1%), Washington, D.C. (23.9), California (21.2%), Idaho (17.9%), Kansas (12.4%) and Mississippi (10.4%) had the greatest proportion of cuts to mental health services during this period.

Meanwhile, Illinois—a state that has cut $187 million during this time—is expected to close three of its nine psychiatric hospitals, and the study reports that up to 5,000 children and adults with serious mental healthcare needs could go without services.

And as states shift a lot of their resources to Medicaid to receive federal matching dollars, the Joint Selection Committee on Deficit Reduction is considering proposals that could result in significant cuts to the program. “As this report prepared to go to press, less than a month before the deadline, proposals to cut Medicaid ranged from $75 billion to almost $200 billion over 10 years,” the report noted. “If adopted, current trends will continue. The mental health crisis in the states would worsen.”