In the mind
January 2009
Andrew McCulloch takes us through the modernisation of the Mental Health Foundation...
The Mental Health Foundation is 60 years old in 2009 and has come a long way since its beginnings as a fundraising committee for mental health research. However, there are recognisable similarities – its evidence-based, solution-focused approach is unchanged. Since I arrived as CEO six years ago, I have been leading a process of strategic change to try to modernise the organisation and to prepare it for the challenges of the 21st century (see also Clarissa Dann's interview with Andrew McCulloch). This article summarises the process of this change and reviews its success.
Policy and research
The Foundation has a strong track record of bringing together talented people from different disciplines to adopt a multi-disciplinary, integrative approach to developing solutions in mental health. For the first 30 years, most of the research undertaken was externally funded, and during this time many research departments and chairs were established with a strong interest in mental health. Having achieved its initial goal of helping stimulate more mental health research, the organisation moved to a more complex, ‘development agency’ model, working round a ‘policy and research in practice’ model (see figure 1):
The idea was that the organisation would have the capability to enter this cycle at whatever point was right for the chosen subject area – for example, some areas of mental health are totally under-researched and would require in-house or external research to develop solutions. Others were quite well researched but required publicity, the development of policy solutions or service improvement consultancy and training to help move local services on. What is critical to the success of this model is a coherent, well-structured business with all the right skills and processes to deliver a complex body of work and to follow through on it.
Organisational capability
When I joined the organisation, this model had been eroded due to lack of resources and this crisis had also generated a lack of focus on strategic issues; governance and senior management was quite sensibly focused on money and basic survival. The organisation had offices in London and Glasgow, an income of around £3.5m a year and some committed staff, which together formed a good platform for development. The initial analysis was that the business model was exactly right, and the unique selling point of the Foundation as one of only two highly differentiated mental health R&D charities (the other being the Sainsbury Centre for Mental Health) was clear, if poorly articulated. My task was therefore to produce a three-year strategic plan that focused on organisational capability (see figure 2).
The model was a simple one with three clear priorities:
- To develop the capability of the staff and organisation to deliver the mission and the business model. This involved recruitment and development of more staff to cover critical areas of the business including research, policy, communications, service improvement and fundraising. It also involved the introduction of more staff capable of working at a senior level externally and mechanisms to develop staff, leading eventually to the introduction of formal management training.
- Robust business systems. These were needed and were developed in priority order, starting with systematic staff appraisal and working through staff handbook development, performance management systems, a financial management information system and project management. All of these have been tailored to the organisation’s specific needs.
- Robust, visible leadership. This was needed from the top of the organisation both internally and externally and this was developed by a combination of recruitment and the development of existing staff, and by providing suitable platforms for senior staff to work on a national level and to lead internally. Part of this work was to make the core expectations of staff transparent and to discuss and clarify them.
Our target audiences
At this stage a good deal of work was done to define target audiences and get the staff team focused on key groups for the work as we had had a number of good projects that had unfortunately ended up communicating with very small audiences. In the end this could be simplified down to four key groups (see figure 3).
We conducted an organisation-wide investigation of which target audience or audiences were being addressed with which piece of work. This soon resulted in a much improved product range.
Some reports which were explicitly aimed at the general public achieved very large audiences; three reports in particular Feeding Minds, Cheers! and Up and Running reached mass audiences [i], backed up by a revamped website that attracts around 3m visits a year. Other reports were more precisely targeted but showed specific impacts within the relevant sectors and some resulted in actual service improvement or policy development which, in turn, led to measurable national or local impact. The end stage of our thinking about communications led to two key changes:
- A rebrand. It was decided not to change our name – Mental Health Foundation – because we do what it says on the tin. We did however give the brand a new set of clothes which are health rather than illness focused (the old brand incorporated a logo of a miserable face);
- The integration of our communications, marketing and fundraising functions. This was to drive single messages out, albeit sometimes using different language and media to address the four key target audiences.
Our seven-point business strategy
Much of the work described above took up the period covered by the three-year strategic plan from 2002 to 2005. At this point both trustees and staff felt some of the basic issues within the organisation had been addressed and it was time now to achieve a step change in impact. It was agreed that this would involve working with all staff to deliver a seven-point business strategy (see figure 4):
Some of the elements represented consolidation of what had been done in the previous three years and some were new:
1. Stronger delivery. This to some extent had already been achieved but it was necessary to expunge a legacy of some poorly designed and managed projects and to ensure 100 per cent delivery of at least adequate, and usually excellent, quality standards across the wide portfolio of projects. The new business systems and the commitment of staff enabled this to be achieved fairly early in the second strategic cycle.
2. Improved brand. The rebrand worked well and market research showed that the brand was strong within the health and social care sector.
3. Higher visibility. As you would expect of a medium-sized charity in a competitive market, the Mental Health Foundation had poor visibility with the general public and this is something we continue to work on. Hard work and investment in the public relations function and the website have been critical to improvements.
4. Better offer. This was related to stronger delivery but also involved articulating for each part of the organisation, whether it was a subject-based programme or a function (e.g. policy) what the offer is. In the case of income-generating parts of the business, this involved creating marketing materials.
5. New business. The organisation had long struggled with developing the right processes to generate new business whether in terms of income generation (where we have developed a £750,000 portfolio) or with charitable trusts. This has been linked to processes to generate new ideas and this process was seen by the senior management team as essential to the organisation’s future success. We therefore debated and created a new ideas process that allows ideas to be generated and flow round the business in a variety of ways.
6. Partnerships. Taken together, increased success in these areas has allowed us to develop key partnerships with a number of agencies, many of them generic – not mental health agencies – that give us greater reach. Three examples are the National Endowment for Science, Technology and the Arts with which we developed the NESTA mental health innovation challenge, Girl Guiding UK with which we developed the friendship challenge for Girl Guides, and the Paul Hamlyn Foundation with which we developed Right Here – a major UK initiative to develop mental health promotion and early intervention services for young people.
7. Innovation. This was the final critical element of the second strategic plan and specifically involving all staff in primary and secondary innovation. Initiatives to generate this include setting up cross organisational hub groups of staff at all levels and disciplines around key issues such as older people’s mental health and setting up ad hoc cross organisational teams to generate specific ideas. This year our Christmas appeal has been generated by such an internal team not by a fundraising agency, leading to greater staff engagement and more cost-effective generation of marketing ideas. Innovation is seen as practical and quick rather than grandiose.
Key elements of our work and outlook for the future
Behind all this work has been an attempt to engage all staff and to ensure that they understand their role in the organisation and their stake and involvement in all key elements of the work – both content and process, and tangible and intangible outcomes. Their reflections on all these key elements of the work are essential to quality improvement (see figure 5).
The next stage of the strategic development process is to take stock and to focus on surviving and thriving during the economic crisis. This will not be easy but I am confident the Mental Health Foundation is strong enough to come through and deliver on its mission which if anything will be of greater rather than lesser importance.
[i] All downloadable from the publications section of www.mhf.org.uk
Author: Andrew McCulloch
Dr Andrew McCullogh has been chief executive of the Mental Health Foundation since October 2002, following six years as director of policy at the Sainsbury Centre for Mental Health.
He spent 16 years as a senior civil servant and was responsible for mental health and learning disabilities policy at the Department of Health from 1992 to 1996.
His PhD study related to spychological adjustment to old age.
Andrew's other experience has included being the chair of Mental Health Media. He enjoys tennis, long-distance running and time with his family
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