Making mental health benefits work

In this session, learn tangible tips for re-motivating an emotionally depleted workforce: 

- What's not working with how we currently approach employee mental health, especially during the pandemic and beyond. 

- What are the DE&I challenges regarding traditional therapy 

- What novel ways can employees be better supported for increased efficacy in professional and personal life, including Underutilized Employee Assistance Programs

Transcription:

Dr. Justin Yang (00:08):

Good afternoon. Thank you everyone for joining us today. My name is Dr. Justin Yang and I am the medical director at Quit Genius. I am also assistant professor of medicine at Boston University and also assistant program director at Harvard Chenko Public Health. So Quick Genius is a leading and leading virtual care platform for substance use disorder and today we have two industry leaders India and John with us today to talk about this topic of making mental health benefits work. And I will have the two panelists introduce themselves first.

Dr. India Gomez (00:50):

Hello everyone. I am Dr. India Gomez. I am a licensed clinical psychologist based in the San Francisco Bay Area small business owner and consultant. I provide direct services as well as consultancy in the areas of mental health literacy, content development around mental health and mental health parody and cultural competency.

John Troutman (01:14):

And good afternoon. I am John Troutman. I am the National Director of marketing with M and S E A P services. We are a national provider of robust employee assistance programs. We are a solutions provider but also a benefit partner with a lot of our clients. That is our main goal. So it is great to be with you all today.

Dr. Justin Yang (01:33):

Thank you. And our third panelist, Amy, unfortunately she is nothing well today, so she won't be joining us but I really look forward to our discussion today. So the topic of our conversation today is making mental health benefits work. And this is I think a very highly relevant topic as we sort of in today's work workplace as we emerge from a pandemic where there is fueled with feelings of isolation, anxiety and depression, and also financial insecurities as well. People are struggling sometimes to return from covid to normal or what we call normalcy or routine daily life at this point. And at the same time, We are also seeing new challenges in this space of facing under utilization of eap or without realizing, hey, the traditional program may not work as well for today's workforce. So today We are going to explore a little bit of these challenges and have this discussion on how do we make mental health benefits work for our employees.

(02:37)

Now I want to dive right into our first discussion topic today, which is as we know what is currently working and with our current approach to employee health and employee wellness mental wellbeing and what is not working well. So I recently read Willis Towers Watson survey and I am quo here that 86% of employers consider mental health stress and burnout the top priorities for the organization in 2022. However, I think there is something clearly not working here with half of the employers surveyed that they are expressing that they do not have a formal wellbeing strategy in place for their workforce and only about a quarter that have articulated that they have a wellbeing strategy. And I think at CU Genius We are also seeing a lot of recent clients perspective clients coming to us with this issue of coming out of the pandemic. there is a significant rise in drinking in alcohol use and a lot of the substance use disorders and they are now looking for a solution to help with that situation.

(03:52)

So I think when we think about mental wellbeing and strategy, you can start with small things. For example, quite genius, we implemented two things. One is me time. So every quarter we have a Friday where it is a day off for everyone and we encourage people to actually go out and have fun and post photos of them actually being outdoors and taking that mental break. We also implemented something called no internal meeting day for every Wednesday so that actually our employees get a chance to catch a break from zoom fatigue from having to fake smile on zooms at the end of every zoom meeting. So I think That is kind of a little things here and there. So I think that is just one example of what we can do and start with. I would love to turn it over to you guys and sort of share your experiences or talk about how to better support employees mental wellness and mental health as we continue to enter into the second half of 2022

John Troutman (05:00):

To go. I can go first on this. That is absolutely, go for it. Excellent. So again, I am speaking from an EAP provider's perspective on this and one of the things that we have seen very clearly in a lot of complaints, quite frankly that we have seen across the entire country is the fact that no benefit by itself really solves anything it needs to be known. Doesn't matter if it is an embedded EAP service or if it is a robust plan. One, and I can give you an example of that. One of our larger clients was over 2000 lives and even before covid were choosing not to allow us to meet with them on a quarterly basis, which is something that we do with all of our clients. And it would not only affected utilization but their own success of those who used the service, they did not have fully understanding of how robust it was.

(05:47)

So being able to communicate that. So That is why the two things I'd like to say Justin, number one is really transparency. And when I talk about transparency, I am talking about the leadership. I really personally believe that those leaders that know the way, show the way and go the way are going to be having people to follow with them as well. It is not just merely sending out that email saying this is a benefit you have, but creating that awareness and that understanding. So walking your management team through that process, what we have seen is the leadership that is decided to use the service first, whether or not they have believed they needed it so that they could understand it and explain it to the rest of their employees is incredibly beneficial and changes how that benefit gets used as well as how it gets understood. So I could go on and on talking about that transparency.

(06:35)

I am a survivor myself of severe burnout so I can speak to what can happen if you do not use those services. So transparency is a big part of that. When leaders can actually talk about their own experiences and share those successful stories. Now you are talking about a story, now you are engaging a person on a real level and now you are speaking human to human regardless of the differences that you may have with those individuals. And it breaks down those barriers that I believe to some extent will always be their mental health. So the transparency piece and also just inspiration, encouraging people, what you have talked about with what you are doing with your company is fantastic. Giving people that space so that they can allow themselves that grace to go and do and be the better version of themselves is fantastic. I think when leaders can inspire their employees to take the time on a daily basis to invest in themselves in all areas of their wellbeing. Now that is a training piece because many people do not know what all the areas of their wellbeing even exist and what that compasses, right? So training and talking about that being transparent but also inspiring them. When leaders can be open and be transparent and talk about what they have dealt with and how they dealt with it, it is going to be much easier for everyone else to participate in those benefits as well.

Dr. India Gomez (07:53):

Wonderful. Those are all really great points from both of you. I can speak to what works on a provider end as well as how I utilize my own advice, which is that I really encourage clients to look at mental healthcare as well as pH, physical healthcare as part of wellness that you do not need to be ill, you do not need to be in crisis to attend to these things that are really make space for it to make sure that you are connected with providers in all of the areas that are relevant to your life as well as engaging in healthy activities. And that some of those are common activities that are about nutrition and movement, those types of things, good sleep hygiene. And some of those are very unique to the individual, whether it is engaging in pleasurable activities that are healthy, hobbies what type of community support they access, whether they are involved in a spiritual community, a religious kind of community.

(08:50)

It is really unique to the individual. So really exploring what are those things that contribute to wellness not just what are the things that put a bandaid on illness or kind of put the pieces together after they have fallen apart. And I really try to model utilization of my own healthy habits of healthcare and of doing my own healthy activities, getting outside moving, spending time with loved ones those types of activities. In terms of what is working about the EAP benefits that I have seen as a provider and a consultant is that it can be a really great introduction to mental healthcare and to substance abuse care and part of the utilization under utilization of those programs. It has to do with mental health stigma, substance abuse stigma, and also just really knowledge about what the programs are. I am thinking back to times, I am a small business owner now, so I suppose I provide my own EAP benefits.

(09:57)

However, when those were available to me in organizations, I did not understand them at all. And I do not think that the managers really understood them and nobody was encouraging use of those services. Or maybe only if it hit a crisis point, would someone speak up and say, oh, we have these types of benefits, would you like to use them? And then there was still a mystery about how to even get through the process. And so the other thing that I am seeing on a provider side is this introduction may be very adequate for some of the people seeking out the services. It might not be adequate for other people's needs in terms of continuity of care if they are at a greater level of severity or they have hit that crisis point or they are under-resourced in other ways, whether they have a caregiver burden or their financial resource limitations, how to transition people to more adequate long-term care and to help them navigate systems of care.

(10:58)

That is something that seems to be lacking on a systemic level as an individual provider, I assist clients a lot with it, but sometimes their sessions are really just sufficient to help them get to the next level of care. So thinking about some flexibility in the model to adjust to that. Not everyone has the same needs which is what John was speaking to and some of our speakers earlier were speaking to that. And so maybe there is a more flexible model of care based on what people's needs are and we could discuss more about what that looks like. Yeah,

Dr. Justin Yang (11:36):

Yeah, definitely. And thank you for those comments. I definitely find it what you said John, about transparency, about opening up the dialogue and lead by example of, Hey, I am using this service cuz as a leader that I know I that mental health wellness is very important. So and any organizations we do see that kind of, if somebody is leading by example of discussing it, opening up a dialogue, people tend to start opening up as well. So I definitely really agree with a point and what you mentioned India, I think transparency, there is also that inherent stigma to it. This is a topic, mental health or even more like substance use, alcohol, even smoking and all that. This has been such a stigmatized topic within our society. So India, I am interested and curious to hear your opinion or your thoughts on has the stigma around mental health, around substance use have them has it been worsening or has it actually gotten better in recent years that people are starting to recognize it and talk about it?

Dr. India Gomez (13:00):

I think That is a complicated question. In some ways I think that there has been some improvement in terms of mental health stigma in terms of stigma around substance abuse because mental health and substance abuse has hit such a crisis level that it is much harder to ignore and it is much more apparent in the workplace, in the media across the country in various areas. However, in some ways there has not been enough improvement or there are a lot of misconceptions about mental health and say connection, some kind of misattributing certain behaviors or topics to mental health or substance abuse that may not be that relevant. That there are a lot of myths about it still that I think we need to dispel. And I do feel hopeful though that as more people are accessing care, that it does become more normalized. I am not sure what you have seen either of you in your observations in recent years.

Dr. Justin Yang (14:09):

Yeah, I definitely think that as you mentioned that it is sort of like we are starting to talk about it, but every step we take forward We are two steps back because of societal reasons or just the overall environment. And there is also a lack of provider as well as we see that traditionally speaking just talking to someone in a traditional brick and mortar in-person clinic can take up weeks. There is a wait list for providers. So definitely I think sometimes we use point solutions and all these emerging point solutions to solve those issues. And curious to John, your thoughts on that. We talk about this stigma and all this taboo in talking about mental health and substance use and things like this. How can employers make their solutions better known and available to employees in a way where that we are considering and thinking about stigma and all these other factors?

John Troutman (15:14):

Yeah, that is great. So sharing real life situations where solutions were met and provided and those can be, I know I mentioned before about the leadership talking about those, but not just really talking about the benefit itself but explaining how it is a solution. Many times we have found that employers and managers misunderstand an EAP that you need to be clinically diagnosed with a condition before you should actually use it. As opposed to what we try to use is the language of any life challenge. So I think we all can attest to having life challenges no one is exempt. And when we break those barriers of you need to be in a certain category or you need to be going through this or that, all of us, we all have challenges and it is how we manage the stress. It is not all those stresses piled up. So it is creating that type of dialogue and communicating it regularly.

(16:06)

I am a marketer, I am not a clinician, so I tell all my groups when I work with them that you need to over effectively communicate as a marketer about the time I am getting sick and tired of my message. Everyone else is finally picking it up. It is a numbers game if you will. So communicating the same thing but in different ways and in different formats. Not just an email, maybe it is a phone call to some people, maybe it is a mail art. I know in our last session someone talked about mailing that information out. So whatever works best for your organization to get that message out, do it in different ways because everyone will receive that differently and appreciate it differently as well.

Dr. Justin Yang (16:45):

Yes, yes, I definitely hear you and I totally agree about the communication part and my personal experience with corgen and other organizations as well that the ones that we see with the most engagement and with the best results and outcomes for their employees are the ones that sort of follows what we call the best practice of communication. And that includes what you mentioned about emails and mailers and all that. And at the same time I think there is still a lot of the organization like HR benefits director, sometimes they do feel like they are still not comfortable with following sort of the best practices of communication because of different reasons. So I think it is definitely something to think about of just how do we communicate And that actually I think is a really great segue to our second big topic here is about EAP and about the underutilization of EAP.

(17:49)

So I think when it comes to mind of what is the first gateway or the steps to mental wellness and mental wellbeing care a lot of the first thing I would think about and employers would point to the employees would be EAP service. And EAP service is great in that it offers sort of a one stop shop for almost everything and from mental wellness, fiscal wellbeing financial legal services as well. However, at the same time because of the topics that EAP has to sort of cover sometimes it is not in depth enough or sometimes people are not utilizing it as they should or could in a sense. I think there, there is studies that I have seen in the past that showed the average e EAP utilization is probably like four, three, 4%. I was at an organization in the past where we looked at 5,000 employees and while we saw EAP utilization of 7% and We are actually pretty happy about it cuz like, oh We are above national average.

(19:05)

A lot of companies like hovering around 1%, 2%. And even in that organization that was with 5,000 employees healthcare organization when we did a survey in ask them, did you know that your EAP service provides three free counseling sessions and more about 70% of the employees out of 5,000 said, no, I do not know this in the past despite us having emails or posting on benefits webpage and things like that. So I think under utilization is a very difficult topic for us to crack and I think it is a good starting point for us to discuss this topic of how do we make and what are some sort of your thoughts on what's happening and why and how can we fix this under utilization issue?

John Troutman (20:06):

Well, I will start us off. Some of the things that we have seen and again every company has is different. It has its own culture, has its own challenges just as each individual has its own culture and its own challenges in life and in business. So we customize all of our solutions based on each client because they are unique and I would encourage every employer to look with that EAP provider that is going to be your problem solver. Maybe they can not solve all your problems but they can work with you to help figure it out. We weekly get calls from our clients asking us questions that are outside the box of a typical eap but we work with them and our response is time and time again we may not have the answer, but let us figure it out together. In some cases it is bringing in and I know India and I were talking about the puppies out there that were incredibly distracting In some cases we are bringing a support dog on site to help ease that transition to get utilization because people would be much easier to see a dog than they would a clinician.

(21:02)

So if you have both, that can be that breakthrough. we have seen that a lot in school districts. For example, we also support a unique client that is in construction. They took on a lot of Amish laborers during Covid and they were not going to do a zoom call with a clinician. They were not going to do a talk session but they wanted face-to-face. So during covid we make sure we boosted our provider network with brick and mortars so that these individuals could have physical access to go and talk to someone and have that access. Now those are two extreme examples. we have also done a partnership with Impact Suite so that we can have technology that'll engage them on a daily basis. So from the end of high end technology to just brick and mortars which have been around forever, to provide and meet those at the individual client level.

(21:48)

So I would encourage anyone in HR to look for those solutions as opposed to just the services and also understand the terminologies of what you are getting. What does a session mean? Is that 45 minutes? Is it an hour? Who are these clinicians you are seeing? Are they certified? Are they master's degree? Are they higher? Who are you seeing? Because in the world of EAP we use similar terminologies but they do not always mean the same thing. So understanding what you are getting and being able to look for that solution provider rather than just a service provider is a big part of getting that utilization up there and communicating with them on a regular basis. Look for that EAP provider that wants to be in front of them. Not all of them may want to do that. So we are in front of our clients about six times a year with customized trainings with utilization reports and other events we have. So they see us at a group level at least six times a year and that is that they do not do anything above and beyond that. So That is a big part of it, staying in front so that you become top of mind as a service. So those are my thoughts.

Dr. India Gomez (22:51):

Wonderful. I wanted to piggyback off of something John was speaking to earlier talking about how EAP can potentially either solve a problem or provide a service that people actually maybe need and want That is not just about being very sick or in crisis. For instance, professional development or personal development, living your best life, self-actualization, coping with stress, effectively managing caregiver burden to really kind of expand the definition or the reason why someone might seek out this service and to help them understand how it could help them in different ways because not everyone will need the same kind of help. So I was thinking about that as you were speaking.

Dr. Justin Yang (23:38):

Yes, yes and I think those are great points. I think one of the things when I think about EAP and utilization of it and how organizations would provide three, five or eight free sessions depending on their packages and what they purchase a lot of times that we do hear that for a lot of issues, it is not just those three sessions That is going to be able to solve this problem. For example, like cogen, we see this issue with people having substance use disorder conditions and they need a prolonged help. So, and That is the reason why we design our program to do 12 months. Cuz recovery from any substances is a chronic, it is going to be a very long period of continuing counseling, continuing talking to a certified clinician to discuss and to motivational interviewing techniques and all that to make sure that they are on their road of recovery and being successful at that.

(24:51)

So I think one of the things that India, we were discussing this before this panel is that cliff when somebody has a three sessions with the EAP service and then a lot of times we do not see that transition to follow up care and that coupled with the fact that a lot of the traditional follow up care that people get are brick and mortar and then there is that two, three months wait before they actually get to see a provider. And so I think there is definitely a lot of things to think about just continuing continuity of care and I do not know if the two of you have any thoughts on that specific topic on or what can we do to improve the care continuum through EAP to another point solution or traditional brick and mortar clinics?

Dr. India Gomez (25:48):

Sure, I can speak to that as a little bit as a EAP provider in terms of how I interact with clients using their EAP benefits. So typically as a provider, I am working with clients right away to assess what their need is and kind of estimate whether or not the allotted sessions would be sufficient to meet their need or whether they might need some ongoing care and what that ongoing care might look like. And it could range from they need more outpatient therapy and they needed infrequently to, they need a lot more frequent treatment or maybe they needed integrated substance abuse and mental health treatment, they might need medication. What are the support systems that they might need? And so I am working with clients right away to help them to also assess their resources. Do they need to use insurance? Can they afford private pay? Do they need to see someone in person?

(26:42)

Do they need a provider specialty? That might be a little bit more difficult to find and understanding as a provider that there are oftentimes even with digital health, that there are oftentimes long wait times or that clients may contact a dozen or more therapists and either not hear back because they are so inundated or they do not take the insurance or they do not have the specialties that they need or that the provider doesn't understand the client issues based on either cultural competency or it is not a great fit. All these barriers to care. So trying to assess what the needs are and to work with the client actively immediately to think about th-eir ongoing care needs. However, that could also be something that e a P companies and employers are thinking of that it is not just on the clinician and whether their orientation is about getting clients continuity of care that to think about how do we help people transition to care or can we assess people even before they are going into their first set of sessions to talk about what else they might need or how they might get it.

(27:56)

Oftentimes people come in and they are so relieved to be able to see someone and then it is so disappointing that they may need to transition their care either because it is not affordable, it is out of pocket afterwards or there is not availability of that provider for long-term care or the specialties aren't there, those types of things. So That is something I am working on as a provider but also thinking about how can we systemically support clients with that is maybe including some kind of care coordination as part of EAP benefits that where it is not taking up their, they only have three to five to sometimes 10 therapy sessions and maybe the coordination of care is taking up all their sessions and they are not getting as much of the actual treatment. So That is something maybe systemically like an EAP or employer could help with somehow.

John Troutman (28:53):

And just if I could just say one thing to that Justin one thing that we do on the very first call when they contact us to set up their first session We are making sure that provider is covered with their health insurance plan. That way if needs to roll over they can stay with that same individual. If they already are seeing a counselor we make sure that that person is associated with their health insurance plan so they can have that continuation. In some cases where they do not have health insurance, we work directly with the employer, obviously we do not get that information of who that individual is, but we ask them and just about every time the employer's willing to make a contribution or cover those additional sessions because they are genuinely interested in that person's success as well. So making sure that at least that, I hate to use the terminology of a safety net, but if that plan is there in case there is that continuum beyond those covered sessions is very important.

Dr. Justin Yang (29:40):

And all those are really great points and I think some of the things that I got out of it is individualized care, it is very tailored, it is very custom tailored to the individual that is seeking support and you know mentioned about cultural competency of the providers and I agree that a lot of times in the past we, cuz there is not enough providers and not of services, we just go to, as you mentioned, whoever that I can get service from. And these days I think this is something that we talked a lot about is DNI and also the diversity in terms of providers and we do have a lot of studies showing that if the patient or the employee that is seeking help is seen by somebody who he or or them recognizes and can talk to that they feel like they are talking to their people basically in a sense of they know what they are going through because of similar cultural background and whatnot. So I think this is a good segue for us to discuss about DNI and I know that our society has gone through a lot in the past three years, not just covid but a lot of social movements as well. So from this point on this aspect of DNI and I am curious to your thoughts on how can employers support DNI and providing a diverse and equitable mental health solution to the employees?

John Troutman (31:30):

Again, I would look for that if you are going to be looking for an EAP provider, make sure that they are working with a diverse network of providers. And I'll use myself as a personal example. So having been through burnout, I did not wanna meet with any clinician except for one who was very skilled in the area of burnout because I didn't wanna go there again. And That is why I am scheduled in the fourth quarter to be preventative maintenance if you will. So we work with a diverse group of clinicians that are very skilled and they keep current of all the different things that are going on in those areas. We are also getting involved in several other things in the education piece. So making sure that EAP provider also educates their own team so they can support you and they can support those individuals that call in because they want to feel supported the moment they engage you, not just when they finally get to a clinician, but along that entire process.

(32:21)

Not everyone who contacts their EAP ever uses the, doesn't always use that service just because you've reached out to them. So supporting them right out of the initial contact so that they can do that. So educating your team, also making sure that those providers are staying current with all That is going on as well. That can also include your technology. We had to make sure that we had, with different clients that we brought on with vision impaired who were vision impaired, we had to make sure that all of our technology resources were able to be seen by them on the technology tools that they were using. So staying current it, it is a challenging world that we live in both with technology and with all the things that are going on. So making sure that that individual feels supported because everyone has a individual experience, they have an individual perspective. So That is why as long as we can keep reemphasizing leading with respect, leading with respect on every level seeing that EAP provider's going to support them at the initial point of contact all the way through those covered sessions and can support them with whatever challenge may be dealing with.

Dr. India Gomez (33:26):

I am so glad that We are discussing this topic as well. And I do have some comments about how to provide care that is more culturally competent for clients. One of the things that Justin mentioned is how relieving it is for clients to encounter a therapist who has some kind of shared identity and maybe it is not possible for that therapist to share all of the identities because we do have complex intersect in intersecting identities. However, some kind of shared point of contact is really important for developing safety in a relationship and it is really one of the biggest one of really big contributing factors to therapeutic change is it is considered a common factor that the relationship with your therapist is really important or your other mental healthcare provider. And so having providers that look like you have shared identities is really important. We also know that there are not enough providers coming from diverse and marginalized communities for a variety of reasons ranging from access to education, which is very, very expensive and lengthy and to reimbursement and whether That is adequate for whatever the circumstances are, there are many layers of that but it is really important to find as diverse of a provider panel as possible as well as making sure that the cultural competency training of the providers on your panel is very robust.

(34:57)

So I just want to speak to those points.

Dr. Justin Yang (35:00):

Yes, and I definitely agree to the robust panel of providers as myself, as a medical director at Cogen. When I look at how do I provide care to our members and especially in the topic of substance use disorder, it is very personal and sometimes I share identity is actually, That is something to get the conversation going. So 70% of our providers are female and more than 40% of our providers identify themselves as people of color. And there is a significant amount of providers that self-identify themselves as part of the lgbtq plus community. So I think with this, when we think about gender when we think about racial race and ethnicity and sexual orientation, just having that robust provider pool is sort of a first key to opening up this topic of diversity and inclusion. And I think when looking at point solutions it is important that people who is creating the program has this kind of concept and putting this into thinking about how to hire providers.

(36:19)

I think we have four minutes left. I do want to go into one of our very last topic. I think it is very timely and sensitive question and that we should discuss about as we know that there is a recent Supreme Court decision that has caused very significant emotional distress and there is a lot of debates on gender equity and care equality for all. And I think this is a very hotly debated topic. So We are not here today to discuss whether the decision by the Supreme Court was correct but I think the point that We are trying to discuss here today is in a situation like this where there is just so much stress, so much distress and mental and emotional distress about this topic, how can we provide us employers to our employees in times like the mental support, mental health support that they need.

Dr. India Gomez (37:20):

I am glad that you have brought this topic to light. It is something that certainly as a clinician on the ground is coming into a lot of sessions that there are a lot of clients who are very distressed about it and are having varied experiences in the workplace ranging from acknowledgement by employers of this is a difficult time and messaging about allyship and about support of what matters to employees, to having experiences in the workplace where nobody is speaking about the elephant in the room and it is very difficult to manage and to keep on keeping on just go on everything is okay when people are not feeling like things are okay for them and they really need some support. And so I think really allying with employees around that, what's important to you, even if it may not be the position of that manager or position of the company, but that what's distressing to you matters to us and that we want to provide care or support or space for that I think is really important.

John Troutman (38:33):

I think That is excellent India, and again, I would go to really any life challenge. I am not trying to belittle this down to something that it isn't, but really when you are looking at an EAP provider for example, it really is any life challenge and just bringing these current events, these current challenges that people are being forced to deal with. Case in point, if you were to talk about a person if they wanted to take that procedure our clinicians are telling them ahead of time where what they are able to speak about and what they can share and what lines could not be crossed in their appropriate state because laws vary as well state to state. So making sure that the opportunity is there, that they have a means of sharing and talking about what they are going through is huge. Showing that support, again, I go back to what India said is a big part of it, and when employers can do that and approach that difficult topic certainly they do not have to give their necessarily opinion on that, but show that they are definitely going to be supportive of them in this individual area is huge and is very helpful for their success.

Dr. Justin Yang (39:32):

Yeah, yeah. So yes, I totally agree with you that it is all about showing support and being there for the employees regardless of what's happening on a society level that they do feel that their voices their voice are being heard and that the employers are standing with them no matter what decisions that they are making in their life with their choices, that we are standing together with them and supporting them. I think That is very important. So I think this We are sort of at time here so if you have any questions from the audience, feel free to come up to us and ask us. I will, for the remaining of the conference here, I'll probably be at where the puppies are. So you can probably find me there. And this is our presentation today and thank you so much for joining us and thank you to you too for being part of the panel. Thank

John Troutman (40:36):

You, Justin. Thank you. Thank you.