A call for urgent action to tackle the level of mental health problems in Dumfries and Galloway has been made.
A report has highlighted the levels of mental health problems
Director of public health Dr Derek Cox said there was evidence of a large section of the local population being in "psychological distress".
That covers a range of conditions including depression and anxiety which can be linked to stress.
Dr Cox said that up to 40,000 people a year in the region were visiting their GPs for help with such problems.
He said it was an issue which had been ignored for too long.
Dr Cox said the scale of the problem was such that, without action, there could be far reaching health, social and economic consequences.
"We are not talking about a few hundred people in Dumfries and Galloway," he said.
He said the figures were likely to be between 20,000 to 40,000 in the space of a year.
These are people who "will experience some form of psychological distress sufficient to really interfere with their lives".
A report into the problem has recommended the employment of a significant number of new therapy staff to help cope with the situation.