Human Resources Committee on Dec. 13th, 2016

[The Chair, Liberal, Bryan May]

Good morning, everybody. I'm glad to have everybody here this morning.

Pursuant to Standing Order 108(2) and the motion adopted by the committee on Monday, June 13, 2016, the committee is resuming its study on poverty reduction strategies.

We are joined this morning by Timothy Diette, Redenbaugh associate professor of economics, from Washington and Lee University. As well, from McMaster Children's Hospital, we have Dr. Peter Fitzgerald, president. Welcome.

Coming to us via video conference, from Hamilton, Ontario, we have Dr. Ellen Lipman, medical doctor, child and youth mental health program. Thank you very much for joining us.

From Pauktuutit Inuit Women of Canada, we have Tracy O'Hearn, executive director.

Welcome to all of you. We don't have as many as we usually have, so we'll give each group 10 minutes today for their opening.

We will start with Timothy. The next 10 minutes are yours, sir.

[Professor Timothy Diette, Redenbaugh Associate Professor of Economics, Washington and Lee University, As an Individual]

Thank you, Mr. Chair and members of the committee.

I'm honoured to have the chance to share some thoughts based on research I have co-authored with my colleagues, Art Goldsmith of Washington and Lee University, William Darity Jr. of Duke University, and Darrick Hamilton at The New School, regarding connections between poverty, unemployment, and mental health. In addition, my comments are also informed by my work as a faculty member for Washington and Lee University's Shepherd program for the interdisciplinary study of poverty and human capability.

I have listened to portions of the recent meetings of this committee and have been impressed by both the quality of the witnesses and the questions from members. I hope my comments will be helpful in the important work of this committee.

Psychologists and sociologists have argued as far back as the 1930s that unemployment damages emotional health and undermines the social fabric of society. Psychologists draw a conceptual connection between involuntary joblessness and mental health in numerous ways, such as incomplete psychosocial development, feelings of helplessness brought on by a perceived lack of control, and failure to obtain the non-monetary benefits of work.

Erikson postulates that healthy personality and emotional development during adulthood requires that a person believe they are making strides to enrich themselves by contributing to their family and community. Otherwise, self-esteem is compromised, leading to anxiety and self-doubt. Seligman asserts that feelings of helplessness arise when a person believes they have little influence over important events in their life, such as securing meaningful work. In his view, prolonged helplessness can lead to depression. Jahoda contends that unemployment is psychologically destructive because it deprives a person of the valued, but unobserved, by-products of employment, including a structured day, shared experiences, and status.

A widespread conviction in psychology is that the response to stressful events, such as unemployment, takes the form of a progression through stages. Shock tends to characterize the initial phase, during which the individual is still optimistic and unbroken. As unemployment advances, the individual becomes pessimistic and suffers active distress, and ultimately becomes fatalistic about their situation and adapts unenthusiastically to their new state.

The unemployed are expected to exhibit poorer mental health due to elevated levels of anxiety, frustration, disappointment, and alienation. Moreover, these feelings are likely to be more pronounced among those who shoulder greater financial responsibilities and persons with a greater sense of self-efficacy fostered by prior success in a host of domains, including school and work. Thus, the highly educated are particularly vulnerable to the debilitating emotional consequences of unemployment. A host of factors may buffer the adverse psychological impact of involuntary joblessness, including an understanding spouse, parents, siblings, adult children, and friends.

Social scientists from a range of disciplines have provided cross-sectional evidence of a connection between unemployment and various indicators of mental health; however, these researchers recognize the potential for reverse causality, where poor mental health can lead to joblessness and thus call their results into question.

Numerous researchers attempt to address this problem by examining persons who switch over time from work to unemployment; however, their findings supporting the link between unemployment and a decline in emotional well-being, although compelling, are not definitive evidence of a causal link, because something unobserved by the researcher may have changed before the onset of unemployment that damaged a person's emotional well-being, such as disappointments at work or unexpected health problems. A second shortcoming identified by Kessler, Turner and House in conventional studies using both cross-sectional and panel data is the selection into unemployment on the basis of prior mental health. This makes it challenging to decipher if unemployment causes poor mental health.

In a recent study, my colleagues and I apply a new strategy to address both of these concerns. We first restrict our analysis to individuals who have never had bouts of poor mental health prior to the last 52 weeks.

This strategy reduces the likelihood that poor mental health causes the unemployment. It also allows us to interpret the effect of unemployment on emotional health for an individual in good mental health prior to the unemployment spell. Note, however, that our results will apply only to this particular subsample. I should also note that all of this is using data from within the United States, and we're always concerned about applying results from one country onto another country.

Second, we separate those in the sample into three groups based on their employment history over the past year, or 52 weeks: those who are employed the entire period, those experiencing less than 26 weeks of unemployment or what I call the short-term unemployed, and those experiencing 26 or more weeks of unemployment or the long-term unemployed. This allows us to test the hypothesis that short-term bouts of unemployment are less traumatic than are longer spells. Our results shed light on a number of key issues, and can be interpreted as causal with greater confidence than can existing findings in the literature.

First, we add to the evidence that long-term unemployment has large negative effects on mental health. Second, the negative effects—again this is in the context of the United States—are larger for black and Latino individuals. Third, short-term unemployment does not significantly harm mental health. Fourth, the potential buffers I mentioned earlier do not appear to substantially change the odds of suffering from poor mental health. Finally, those with more education suffer a larger emotional penalty for being long-term unemployed.

The body of evidence offered by social scientists, including psychologists, suggests that to ignore mental health costs is to understate the negative effects of long-term unemployment. Thus, public policies aimed at improving labour market performance should account for the mental health costs of joblessness. Our research highlights the importance of implementing policies and programs that reduce unemployment, especially long-term unemployment. Moreover, public policy should be mindful of the support needed by those who are long-term unemployed.

Unemployment is not the only traumatic event associated with negative effects on mental health. In a series of studies with the same co-authors mentioned earlier, I've examined the effects of other traumas, namely, sexual assault, violence at the hands of parents, violence by others in the community, and stalking. All of these traumas, whether experienced as a child or as an adult, are associated with either current or subsequent negative effects on mental health, happiness, and education outcomes for children. We examined those in separate papers.

Unfortunately, these traumas are associated with being in poverty. All of this evidence highlights the importance of taking a full accounting of all the costs associated with poverty. This suggests that while effective tools for fighting poverty may require significant resources on the part of government, the alternative—more people in poverty—carries significant monetary and non-monetary costs to government, individuals, and society as well.

Thank you, Mr. Chair and members of the committee. I look forward to your questions.

[The Chair, Liberal, Bryan May]

Thank you very much.

Now from McMaster Children's Hospital, we have Dr. Peter Fitzgerald, who is the president, and by video conference, Dr. Ellen Lipman.

The floor is yours.

[Dr. Peter Fitzgerald, President, McMaster Children's Hospital]

Thank you.

Good morning and thank you for the opportunity to speak with you today. I am joined by Ellen Lipman by video conference, as you mentioned. I just want to point out that Dr. Lipman is the head of our child and youth mental health program at the hospital, which is one of the largest programs in Canada. She's also one of the lead researchers in this field within Canada. I think you'll find her part of the presentation to be very informing.

I want to start by commending the committee for its work in studying poverty reduction strategies, and particularly its decision to extend the scope of its important work to include mental health issues.

To frame Dr. Lipman's part of the presentation, I want to say a little bit about Hamilton, Ontario. As Ms. Tassi knows, Hamilton is commonly identified with the steel industry, at least historically, but today Hamilton is a diverse city of over 500,000 residents. About one-quarter of our residents were born outside of Canada. While there is income variability across Hamilton, poverty is apparent. The Hamilton urban core is identified as one of the areas in the province of Ontario with the highest percentage of the population living in poverty. Part of Hamilton's vision is to become the best place in Canada to raise a child. However, in Hamilton approximately one in four children lives in poverty. The links between poverty and child and youth mental health are very meaningful for those of us who live and work in Hamilton, particularly for those of us in the health care sector.

Now I would like Dr. Lipman to discuss the very important relationship between child and youth mental health and poverty, and to outline strategies we believe will help with this issue.

[Dr. Ellen Lipman, Medical Doctor, Child and Youth Mental Health Program, McMaster Children's Hospital]

Thanks very much.

Again, thanks for the opportunity to present today. I am going to talk about the relationships between child and youth mental health and poverty, but I want to begin by giving a brief overview of what we know about child and youth mental health difficulties.

According to the global burden of disease study, mental health and substance use disorders are the leading cause of disease burden worldwide, and Canada is no exception. While we often think of these disorders as disorders of adulthood, it's important to recognize that they emerge early in the life course, with estimates of over 1.2 million Canadian children and youth, or roughly 20%, being affected by a mental health disorder.

There is a large burden of suffering associated with child and youth mental health problems, including the impact on the children themselves and on the families, and costs to the health, educational, and judicial sectors, to name a few. It's troubling that many of these children did not receive specialized mental health services. If left untreated, the consequences are profound, causing significant distress and impairment throughout the life course. Up to three-quarters of adults with mental health disorders date the beginning of their difficulties back to childhood or adolescence.

Many children and youth with mental health problems are exposed to poverty, and there is a dynamic and bidirectional association between child and youth mental health disorders and poverty. While we often think of poverty as a determinant of poor mental health, it's important to acknowledge that poor mental health can contribute to poverty.

First, I'll focus on child and youth mental health problems influencing poverty. We know that these problems are common and can influence children and youth in many ways. For example, children with mental health problems may have trouble doing the things that most children are able to do in that developmental stage, such as progressing in school, having successful friendships, and getting along with their siblings, teachers, and parents.

Prospective studies that follow these same children into early adulthood provide compelling evidence for the long-term adverse effects of childhood mental health problems on young adult functioning. For example, 60% of young adults who experienced a childhood mental health problem report adverse adult outcomes, including high school dropout and unemployment, compared to 20% of those who did not experience a childhood mental health problem.

Additional adverse adult outcomes include physical and mental health problems, problems with social functioning, and legal problems. These impairments in adulthood clearly influence financial and occupational stability and can contribute to poverty.

Second, I'll focus on poverty influencing child and youth mental health. Children living in poverty are two to three times more likely to develop mental health problems. Parental nurturance, cognitive stimulation, and an accumulation of exposure to related psychosocial risk factors can all help explain why children growing up in poverty are more likely to experience mental health problems. For example, children who live in poor households may have parents with their own physical or mental health problems, who have struggled in school and who have difficulties maintaining stable employment or ensuring adequate resources are available to the family. A living situation may be crowded and provide less cognitive stimulation, which may contribute to poor academic outcomes.

Early exposure to poverty has been linked to worse mental health in emerging adulthood as a result of an accumulation of exposure to associated psychosocial risks such as family turmoil and family separation, and physical risk factors such as substandard housing and crowding. It's clear that the experience of childhood poverty modifies dimensions of the personal, familial, school, and community context that children need in order to thrive and contribute meaningfully to society.

I want to end by focusing on six recommendations for mitigating the effects of poverty on child and youth mental health.

Number one, start early. This will allow preventive and early interventions that address early childhood emotional behavioural problems and are likely to have the highest impact, since trajectories of these problems are often established early and tend to persist over time, and the ability to change behaviour and brain plasticity decreases over time.

Number two, provide service at the right time. This will allow a focus on developmentally sensitive periods, such as early childhood and pre-adolescence, early in the course of symptom presentation or illness.

Number three, we want the right identification. From the broadest perspective, the right identification requires increased ability to recognize concerning behaviours, and that means increased education about what the scope is of normal behaviour and what the early signs are of mental illness for youth and children. With the right identification, more systematic identification may occur through established systems of care, such as regular baby and child visits to primary care. This will need associated investments in the primary care system to work. We also want identification that is supportive and not stigmatizing.

Number four, increase the availability of services. We propose increasing the training of allied health professionals and increasing the funding of mental health initiatives for children and youth.

Number five, provide service in the right place. We propose providing universal and targeted programs for prevention and early intervention in community and health agencies, where children at high risk and families with needs will present.

Number six, provide the right intervention. We want to use interventions that target modifiable risk factors, such as caregivers, mental illness and coping, and positive parenting strategies. We want interventions that are multi-systemic and cross-sectoral, so we can target not only child difficulties but also the social needs of families. We also want to use interventions that have evidence or to ensure that interventions are evaluated, if they're used. We certainly don't want to cause harm, and we want to evaluate cost-effectiveness.

We want to thank you again for the opportunity to present in front of this committee.

[The Chair, Liberal, Bryan May]

It's our pleasure. Thank you very much.

Now from Pauktuutit Inuit Women of Canada, we have Tracy O'Hearn, executive director.

Thank you.

[Tracy O'Hearn, Executive Director, Pauktuutit Inuit Women of Canada]

Thank you very much.

Ullakut. Good morning. Bonjour. On behalf of our president, Rebecca Kudloo, we thank the chair, vice-chairs, and members of the committee for inviting us today. We greatly appreciate the opportunity to bring forward the issues and priorities of Inuit women across Canada. President Kudloo lives in Baker Lake, Nunavut, the geographic centre of Canada. She was not able to be here with you today.

We hope our testimony and participation will contribute to fulfilling the Prime Minister's commitment to a renewed relationship with first nations, Inuit, and Métis that is rooted in reconciliation. We also appreciate the Prime Minister's commitment to gender equality. We look forward to a demonstration of that.

My comments today are very much linked to the testimony of previous witnesses, although I bring forward a much broader view. Today I'd like to situate for you the relevant issues in Inuit communities in the context of poverty. After providing a high-level view of different types of these prevalent issues, I will then talk about the three most pressing areas of concern: the lack of housing; violence against women, including the sexual abuse of children; and the pervasive and chronic lack of child care—generally not available—let alone the early childhood interventions and range of services taken for granted in southern Canada.

It's also important to note that Inuit are the youngest and fastest-growing population in this country. From the last statistics that I recall, more than 50% of Inuit are aged 25 or younger. That's significant now, and it's significant for the immediate, mid-, and long-term future.

For decades there's been a housing crisis in Arctic communities that is only getting worse with each passing year. It's important to remember that it's only been two generations since Inuit were moved into permanent settlements. Before that they lived a nomadic, subsistence lifestyle based on a traditional economy. Immediately upon moving into communities, people were faced with foreign institutions of governance, education, and justice. There was an immediate and profound cultural disruption and cultural dislocation, still being felt today.

All of these things were well documented by the Royal Commission on Aboriginal Peoples, and touched upon specifically with regard to residential schools by the TRC. We are very pleased that this government is committed to fully implementing the 94 calls to action as well the United Nations Declaration on the Rights of Indigenous Peoples.

The housing crisis, as part of the Inuit experience of colonization, has created and worsened social issues, including violence against women and children, substance abuse, suicide, and significantly poor mental and physical health status. Poverty reduction in Inuit communities, particularly for Inuit women, cannot be addressed in a vacuum. All of these issues must be addressed in a holistic population- and gender-specific manner.

In a recent survey that we did of 130 Inuit women, they identified housing and homelessness as the most serious and urgent issue in Inuit communities. They also noted the lack of child care as being a significant barrier to education, training, and employment opportunities.

When we arrived here, my colleague reminded me that according to Statistics Canada, in 2014 in Nunavut 45% of young children lived in poverty. That's 45%. Inuit women and children also live in the regions of Canada with the highest rates of violence and the highest crime severity index outcomes.

A recent piece on CBC North reminded everyone that for Inuit in Nunavut, a fairly recent Inuit health survey indicated that 52% of Inuit women and 22% of men reported they suffered sexual abuse as children. Considering these numbers, these rates, in relation to the testimony of the other esteemed witnesses here today, I know you can appreciate the magnitude of the urgent need.

There are 53 communities across Inuit Nunangat, the four Arctic regions of Canada. Of those 53 communities, 70% do not have a safe shelter for women and children, let alone things like wraparound supports for victims and survivors of child sexual abuse. It simply isn't there.

The majority of Inuit communities do not have access to mental health programs, certainly not to the extent available in southern Canada. They're simply not present. In part, because of these issues and other circumstances raised by other witnesses, there is pervasive unresolved trauma. This year we produced a strategic plan for violence prevention and healing. It's available on our website. I didn't want to take up a lot of time with its very detailed recommendations. We squarely talk about child sexual abuse.

To touch briefly on suicide, the estimated number of deaths per 100,000 in each of the four Inuit regions are as follows. It's 61 in the Inuvialuit region, which is the western Arctic. In Nunavut, it is 120 per 100,000. It is 181 in Nunavik, which is Arctic Quebec. It's 239 in Nunatsiavut, the north coast of Labrador. That's compared with the national suicide rates for the Canadian population of around 11 deaths per 100,000.

As noted, poverty contributes to mental stress and other social issues. Mental health challenges absolutely can prevent individuals from building sustainable livelihoods, whatever that may be for that person according to their own measures of success.

Applying a cultural lens, an Inuit-specific lens, is critical to appropriately understanding and addressing the complexity of the situation and certainly the urgency. As I mentioned, we now have an opportunity for Canada to address these and other issues through a full implementation of the United Nations Declaration on the Rights of Indigenous Peoples.

We had an opportunity to read some of the testimony of witnesses who have appeared before you. Without hesitation, we support the recommendations brought forward by Canada Without Poverty and West Coast LEAF.

Through whole-of-government co-operation, we hope to succeed in developing new and more robust strategies for tackling these challenges to reduce poverty, and particularly those experienced by Inuit women.

I thank you very much for your time. I look forward to and welcome your questions.

[The Chair, Liberal, Bryan May]

Thank you, Ms. O'Hearn.

You mentioned a website and specific recommendations. You said they were in great detail. You didn't want to talk about them in your opening. Would you mind sending those to the clerk for our consideration?

[Tracy O'Hearn]

I brought a copy. It's my pleasure to leave it. We'll be happy to continue our conversation.

[The Chair, Liberal, Bryan May]

That's perfect, excellent.

Thank you very much.

I was remiss at the beginning. I didn't welcome a visitor today. We have MP MacGregor joining us.

[Alistair MacGregor, NDP, Cowichan—Malahat—Langford, BC]

I'm happy to be here.

[The Chair, Liberal, Bryan May]

Thank you for filling in.

We're going to get started right away with questions.

First up, we have MP Zimmer.

[Bob Zimmer, Conservative, Prince George—Peace River—Northern Rockies, BC]

Thank you, Mr. Chair.

Thank you to the witnesses for appearing today.

I have two questions, and they're a bit long.

Timothy and Tracy, the study is about reducing poverty. Certainly we've talked about the conditions related to poverty. From my perspective, I'd like to see it prevented in the first place. As I've said before, there's the ER when we need immediate care for people who are in trauma, but we also want to prevent the accident in the first place. You can call the accident “poverty”, if you want to use the comparison.

Timothy, you talked about certain conditions of poverty, the effects of poverty, etc. Because this is a study to reduce poverty, what strategy would you employ to reduce poverty?

The same question goes to Tracy. Especially with Inuit communities, how would you reduce poverty?

We'll start with Tim.

[Prof. Timothy Diette]

I think you're getting it from the economists, at least from the evidence that we've seen, that prevention is much more effective. Frankly, a couple of the suggestions that were given by fellow witnesses, with the six points that they laid out, particularly starting early....

Thinking about early childhood development, I think of the the work of Nobel Prize winner James Heckman, who focused on early childhood intervention. It's true across disciplines. It's not just economists who are talking about that, as we've already heard today.

Investing early—and we discussed the importance of how much easier it is for these interventions to be successful early on—I think is the most successful. The challenge is always trying to intervene and what you do for older individuals, where we've missed that.

That would be my short answer.

[Bob Zimmer, Conservative, Prince George—Peace River—Northern Rockies, BC]

Tracy.

[Tracy O'Hearn]

Thank you for the question, and it is a broad question.

I think there is an immediate need to invest in housing. It's essential to address some of these basic living conditions in Inuit communities that are still described by some as third world. Early childhood interventions, early learning, supports for children, are absolutely critical.

Concurrent with that must be addressing the violence, addictions, and other social issues that far too many children experience, and food insecurity. Children are hungry up north. There are so many needs that are required, but I would say that these are amongst the most urgent, immediate interventions that are required.

[Bob Zimmer, Conservative, Prince George—Peace River—Northern Rockies, BC]

I'd like to talk a bit more about what you just suggested, Tracy.

You talked about certain conditions in Inuit communities. I don't know if you mentioned depression, but I know it's up there. There's a high suicide rate. There are different effects from the conditions.

However, what do you think is the root condition? I think you talked about the original ways of the Inuit people changing in the last 50 years. I don't want to put words in your mouth, but I think you said about 50 years.

[Tracy O'Hearn]

About two generations.

[Bob Zimmer, Conservative, Prince George—Peace River—Northern Rockies, BC]

Yes.

In looking at this, “preventative” is a word that's important to me. How would you deal with those conditions? You're talking about housing. You're talking about the rest. You're talking about issues in the home, let's say, and violence in the home. How do we stop that? It's easy to say that we need to reduce it, but how?

I guess that's my question. I look at other conditions in Inuit communities too, such as high unemployment rates. There's not much to do up there. They're literally sitting there, watching time go by.

You had suggested getting back to the ways of their original economy. How do we get back to that, away from these conditions they are now in? Is the community asking to get back to the way it was 50 years ago? If they are, how do we get back to that time and place in their lives where it was good? How do we get back there?

[Tracy O'Hearn]

I haven't heard anyone speaking about wanting to return to a nomadic lifestyle and being dependent on the fur trade. We're a long way from that. I think what has changed is individuals' perceptions of having control over their lives—autonomy, self-determination. There's no quick fix. We have to remember, as well, that most communities are only served by a health centre. There are no resident physicians, let alone specialized supports. I think we need to look at alternate ways of delivering services to remote communities.

We would echo many of the issues that Cindy Blackstock has brought forward very eloquently around the number of Inuit children in care. All of those issues affect Inuit children. I wish I could give you one answer, but I think, more broadly, it's to restore control and autonomy.

Through an initiative we did, funded by Status of Women Canada, we had an opportunity to do a culturally relevant, gender-based analysis related to violence and encouraging men to prevent and reduce violence. That's where we were able to develop a lot of qualitative evidence around the changes—immediate changes—to Inuit culture and autonomy, which have disproportionately dislocated Inuit men because they're no longer feeling valued in their traditional roles as hunter, i.e., provider. It can be related to unemployment due to cultural changes.

There's no quick fix. I think there are a number of recommendations that have been made. But we have to start immediately feeding children, making sure that children are adequately nourished, for their bodies, for their minds, so they can grow. I wish I had one solution that I could give you, but it's complex.

[The Chair, Liberal, Bryan May]

Thank you very much. That's time, unfortunately.

MP Tassi, please, you have six minutes.

[Filomena Tassi, Liberal, Hamilton West—Ancaster—Dundas, ON]

Thank you, Mr. Chair.

I'd like to begin by thanking the witnesses for their testimony and for their work in this very important area.

I'd like to direct my questions to Dr. Lipman. In your testimony, at least five of your recommendations, and arguably six, have to do with access and early intervention, so I'd like to focus on that.

My experience with youth as a counsellor, over 20 years as a chaplain, was that it was very hard to access mental health services. In your practical experience in this area, are youth who are in need of mental health services getting those services? Maybe you could talk about wait times and what the problem is with respect to early intervention and early access.

[Dr. Ellen Lipman]

That's a great question with a complicated answer. Some of what can be helpful in terms of understanding this issue is one of the suggestions I made, which is really more general education about what the range of normal is and what concerning sorts of behaviour or early signs of mental illness are. Part of the reason for thinking about that education broadly is so that the people who are coming to you for mental health services are the right ones who need that kind of help. That might close the bottleneck, getting the right people to the services that are needed.

Another suggestion might be this idea of broader training for people so that there is more access to mental health services.

Currently, the organization of mental health services is complex. I'd say the place where most commonly children or youth might present would be in their family physician's office. Making sure that family doctors have good knowledge and know about resources in the community is a really important way of getting people to the right services.

Within Hamilton anyway, the services are part of two Ontario ministries. Some are part of the Ministry of Health, and some are part of the Ministry of Children and Youth Services. That makes it complicated as well.

What I can say from the point of view of the Ministry of Children and Youth Services in Ontario is that they have an initiative where, within each region or within a number of specific regions of Ontario, they try to have a really good understanding of what's available in that community so that, at the end of this process, each parent in each community should know, “If my child has trouble, this is where I go and these services are available in the community”. It's called the lead agency initiative.

That's sort of broad. I guess the one thing I didn't talk about was waiting lists.

[Filomena Tassi, Liberal, Hamilton West—Ancaster—Dundas, ON]

Yes.

[Dr. Ellen Lipman]

I can only comment on our specialized services in Hamilton. We do have a waiting list for people who are coming for consultation and people who are coming for assessment and treatment in the children's mental health sector. We try to prioritize based on a number of things that have to do with risk or presentation to the emergency room, so that the people who are the most acute don't wait the longest. I wouldn't say it's a perfect process, but that's the way we try to manage that.