Almost 90,000 Americans say they have developed anxiety or depression as a result of the COVID-19 pandemic, according to a new report by the nonprofit group Mental Health America(MHA).

More than 21,000 Americans who completed the group’s free online mental health screening in May said they thought about suicide or self-harm on more than half of the days last month, HealthDay reports. Almost 12,000 people reported these thoughts nearly every day.

“Our May screening numbers were unprecedented,” MHA President Paul Gionfriddo said in a news release. “And what is most troubling is that the numbers — consistent with the numbers from the U.S. Government’s Census Bureau — demonstrate not only that there is not yet any relief from the mental health impacts of the pandemic, but that the impacts actually seem to be spreading and accelerating.”