Recognition that there's a dearth of spending for mental health is entering politics this year as candidates on the Right and the Left begin to ask why state budgets are spending more on prisons than treatments. In Florida, it is a fiscal conservative candidate for governor who wants to use ankle bracelets to release prisoners with a substance use disorder to community treatment. His campaign called attention to the shameful ranking, one that Politifact confirmed was true.

Florida, Texas, and New Mexico alternate in the lowest rankings on the list of spending from survey to survey. In 2006, according to the Kaiser Family Foundation when the rankings were compiled, New Mexico ranked last (51st, including the District of Columbia), spending $25.58, Texas ranked next to last spending $34.57 per person, and Florida third from the bottom, $38.17.

Per-capita rankings do not differentiate between the amount dedicated to state hospitals versus community-based treatments that are less costly. Still, in 2009 when a candidate for lieutenant governor in Texas said his state was last, advocates weighed in quickly to explain what that meant, including waiting lists, shortage of services, increased caseloads, and months-long delays between appointments.