DENVER – Mental illness and substance abuse affect three Coloradans in 10, yet often people are unaware that their friends and relatives are affected, according to a report out this month from Advancing Colorado’s Mental Health Care.

The report assesses how widespread mental health-care needs are in the state and what the state is doing to address them.

Lead author Dr. Andrew Keller says this is a hidden health crisis.

“There’s a lot of stigma around substance-abuse problems and around mental health. Stigma is real, and I think we need to make it OK to talk about, you know, ‘I have depression,’” he said.

The report found that about 1.5 million Coloradans are afflicted with mental illness or substance-abuse issues. And it found that state spending on mental-health care remains insufficient, at about one-third the national average.

The state’s Chief Medical Officer, Dr. Chris Urbina, says the holiday season can be especially trying for people struggling with mental illness or substance abuse.

“It’s the holiday time, the timing that reminds people of those challenges in their lives, not the push to be festive.”

Dr. Urbina says family and friends need to understand that these conditions aren’t a choice.

“Mental illness and substance abuse are real, serious physical and mental issues and need to be taken seriously to get therapeutic help. You can’t wish to be better,” Urbina said.

Advancing Colorado’s Mental Health Care is a five-year-long project designed to improve mental-health care in the state. It’s a partnership of four organizations: Caring for Colorado Foundation, the Colorado Health Foundation, The Colorado Trust, and The Denver Foundation.