More than 4 in 10 Americans are struggling with mental health issues stemming from the coronavirus pandemic, a new survey found.

The most recent Morbidity and Mortality Weekly Report from the Centers for Disease Control and Prevention revealed that 41% of respondents have faced mental health challenges related to COVID-19 and steps taken to combat the pandemic, including social distancing and stay-at-home orders.

Taken from June 24-30, about one-third of respondents, or 31%, said they were experiencing anxiety or depression symptoms. Thirteen percent said they had started or increased substance use and 26% said they were experiencing trauma or stress-related disorder symptoms.

Eleven percent of respondents said they had seriously considered suicide in 30 days prior to the survey.

“U.S. adults reported considerably elevated adverse mental health conditions associated with COVID-19,” the report said. “Younger adults, racial/ethnic minorities, essential workers and unpaid adult caregivers reported having experienced disproportionately worse mental health outcomes, increased substance use, and elevated suicidal ideation.”

According to the CDC, the prevalence of symptoms of anxiety was approximately three times those reported during the same time period last year.

Respondents 18 to 24 years old were most likely to suffer mentally from the pandemic, with 75% of the age group saying they had at least one adverse mental or behavioral health symptom. About half, or 52%, of people aged 25 to 44 years old said the same.

Younger people were also more likely to consider suicide, with 25.5% reporting they had thought about it in the previous 30 days.

Suicidal thoughts were higher in minority racial and ethnic groups. Nearly 19% of Hispanic respondents reported suicidal ideations and 15% of non-Hispanic Black respondents said the same.

About 22% of essential workers and 31% of unpaid caregivers also reported seriously considering suicide in the 30 days prior to the survey.

“Addressing mental health disparities and preparing support systems to mitigate mental health consequences as the pandemic evolves will continue to be needed urgently,” the report stated.

The U.S. has the most cases of the coronavirus in the world, with more than 5.2 million. More than 166,620 people have died in the country from COVID-19. Across the globe, officials report more than 20.7 million cases and more than 751,260 deaths.