The Great Recession is a term covering the period from December 2007 until June 2009 that saw a significant shrinking of the American economy. The collapse of the housing market, which had grown significantly on a foundation of marginal loans, triggered the downward spiral of financial markets, consumer spending, and unemployment. By the end of this 16-month period, it was estimated that the labor market lost more than 8.4 million jobs.2 In December 2007, the national unemployment rate stood at 5.0 percent; by June 2009, it had risen to 9.5 percent and continued to climb for a few more months; by October 2009 the unemployment rate was up to 10.0 percent nationally.3 Although the last 4.5 years have seen significant economic recovery, the labor market has not rebounded to its pre-recession levels: In December 2013, the national unemployment rate still stood at 6.7 percent.4
In response to the recession and the slow recovery process, in 2010, the Substance Abuse and Mental Health Services Administration (SAMHSA) launched the Community Resilience and Recovery Initiative (CRRI). CRRI was a multi-level, place-based demonstration project aimed at helping grantee communities cope with the ongoing behavioral health effects of the Great Recession. SAMHSA funded three grants based on applications submitted in response to its Request for Applications (RFA): Union City, New Jersey; Fall River, Massachusetts; and Lorain, Ohio. Each applicant was awarded up to $1.4 million a year for up to 4 years to improve the coordination and availability of behavioral health services in their respective communities. More details about specific grantee requirements are set forth in the following chapters.
In addition to these implementation grants, the Office of the Assistant Secretary of Planning and Evaluation (ASPE) within the U.S. Department of Health and Human Services awarded Westat a contract to evaluate the initiative throughout its duration. The objectives of the evaluation were threefold: First, to describe the characteristics of grantee implementation processes, including social marketing efforts, screening procedures, brief interventions, and referrals to services; second, to report on the individual-level outcomes achieved by each of the grantees; and finally, to assess the extent to which this place-based initiative was able to improve community-level resilience in the face of adverse economic circumstances. An additional contract to support the initiative was established between SAMHSA and the National Association of State Mental Health Program Directors, whose staff conducted background research for the grantees on various evidence-based programs (e.g., suicide prevention, employment training and support). SAMHSA also contracted with Gallup to provide technical assistance to grantees as they developed their community media campaigns.
Although there was the potential for grants to extend for up to 4 years, funding was only available for 2 years. This significantly changed the trajectory of grantees' program implementation efforts, as well as the evaluation design.
This report summarizes our evaluation findings for this abbreviated, but important initiative. In the next chapter, we provide an overview of the RFA, which sets forth the objectives of the grant as well as the responsibilities of the grantees. We also provide a brief description of each of the grantee communities, emphasizing those community characteristics that made each awardee an apt candidate for this endeavor. Chapter 1 concludes with a discussion of how funding for 2 years instead of 4 years impacted both the implementation by the grantees as well as the Westat evaluation design. Chapter 3 focuses on the grantees' efforts and is divided into a separate section for each grantee community. Consistent with our evaluation goals, we describe the implementation processes for each grantee and detail their respective accomplishments in their communities. In Chapter 4, the reader will find our analysis of individual-level and community-level outcomes. For the former, we summarize the findings from the Services Accountability Improvement System (SAIS) data received from SAMHSA, including the characteristics of individuals who were enrolled in the CRRI program in each community; outcomes for key indicators, such as substance use disorders, employment, and mental health; and, where feasible, details about program effectiveness. Although the findings do not imply causality, the tables and graphs in this chapter clearly indicate that enrolled clients evinced improvement in both employment and behavioral health indicators over time. This chapter also includes a discussion about the community-level data and some of the challenges associated with that analysis. Chapter 5 provides a brief summary of the evaluation findings and implications for future place-based initiatives.