Kooth (LSE:KOO) — Half Year Results

0:00 Good afternoon, and welcome to the KOOTH PLC investor presentation. Throughout this recorded presentation, investors will be in listen only mode. Questions are encouraged and could be submitted at any time via the q and a tab situated on the right hand corner of your screen. Simply type in your questions and press send. The company may not be in a position to answer every question it receives during the meeting itself. However, the company can review all questions submitted today, and we'll publish those responses where it's appropriate to do so. Before we begin, I'd like to submit the following poll. And I'd now like to hand you over to Tim Barker, CEO. Good afternoon, sir.

0:31 Hello. Thank you for the introduction. Just wanna check if you can all hear me. So we're broadcasting to you today from our Paddington office in London. Delighted to walk you through the first half year results, give you the highlights, fill out the details on the backstory of our progress, and, of course, answer any questions you've got. So please put your answers or questions in the q and a while I'm going go through those. So just to start with highlights for the first half of the year, an incredible year for us as we tackle this growing crisis in youth mental health and then to turn the tide by making digital access the primary way that we can get support early. So four key things in the first half of the year that we'll go on and talk more about in today's session, our progress in California where we launched our next generation platform, Soluna, on January 1. We're seeing great positive early outcomes and feedback from young people that are using the service.

1:32 About a month ago, we went live with a partnership with Aetna in Illinois to help tackle health inequality by providing support to low income families that qualify for Medicaid. In other states, pleased to announce that we have received a funding award in Pennsylvania from the Department of Human Services, building on the pilot work we did back in 2022 and '23, and we have got visibility that we can see a two additional pilot contracts expect to be signed this calendar year. Finally, we'll talk a bit more about The UK. Obviously, the NHS is going through a tough time at the moment with with real financial pressure and a real focus on trying to clear those elective care backlogs.

2:18 But there are some green green shoots of future policy that we'll talk more about. And a brief reminder that when we would have spoken to you two years ago,

2:29 zero percent of our business was in The US, and now it's 70% and growing. So I think in addition to really scaling up as a company to help tackle this global crisis in youth behavioral health, it's a great story in exporting and how we can help grow the economy for everyone. Great. Thanks, Tim. So taking a look at the financial highlights for the first half, I know some of these results were quite well flagged, but we're absolutely delighted with record revenues, record margins, and a record adjusted EBITDA. Diving into a little bit more detail. So revenue for the first half was 32,500,000. That's a 179% growth over the same period last year. Of that 32,500,000 revenue, around 23,200,000 came from The US. That's about 70% or so, and that's been predominantly driven, I think, everyone knows, by our California contracts.

3:26 California launched on the January 1. The remaining the remaining revenue, which was in The UK, was down a little bit, so around five and a half percent on the corresponding period. And we'll talk a little bit more about some of the some headwinds that we've seen in The UK in the first half of the year. ARR growth, recurring revenue was also equally strong, up 181% to 60,000,000, and, again, very much driven by the California contract. And that gives us great visibility on revenue over the coming coming twelve months or so. And, you know, around over 95% of our revenue now comes from the contract, from contracts that are twelve months or longer in period. Gross margin was up very strongly, up to 82.4%, 15 percentage points up. Three factors behind that were worth worth sort of bearing in mind.

4:21 The first is that it's part of our overall four year contract with California. There were some of the revenues that we'll be receiving from California are a contribution to developments of the SLUNA platform. If we if we remember, you know, the existing KOOTH platform covered about 70% of what California were looking for, but we've developed a separate platform building on that. It's called SLUNA, which we've been investing in quite strongly over the last twelve months or so. California have contributed to some of that some of that investment through the revenue line. Those product development revenues do not have a direct cost associated with them. The costs either come through the overheads line or are capitalized and amortized. So that's given us a two, three percentage point uplift in gross margin, which we would expect to fall back a little bit over the coming years as the product development aspects of the contract is completed.

5:24 In addition, we've been very pleased to see in the first six months of the launch in California a greater uptake in the use of the overall platform, self guided tools such as, content, community, self help tools, journaling, goals, etcetera. And

5:47 that's reduced the initial requirement for professional support from our California practitioners, which again has helped the gross margin. I think, you know, as users start to become a bit more familiar with the platform, they may gravitate back towards professional support. So we we think, you know, the gross margin drop back a little bit to a more normalized, perhaps 75% or so level as a result of that. And finally, what we typically see in the first few months of a new contract is a bit of a ramp up period whereby our focus and resources are more based around marketing and engagement of the service as we're starting to get users aware of service, and we're starting to, you know, get get look acquire more users to the platform.

6:41 So spend is predominantly skewed towards marketing and engagement efforts, less so than usage of the practitioner base. So we've seen a little bit of a benefit from that with direct costs lower in the half in the first half, and that's been offset by some higher marketing expenses. As we start to see more and more usage of the platform, professional support costs will increase, but there'll be an equal and opposite sort of offset on marketing expense. Finally, we saw a very strong growth in EBITDA to 7,800,000 sterling. Adjusted EBITDA, excuse me, for the first half. Please don't sort of double that number and expect us to end up at that for the full year. We would we will see some costs skewed to the second half of the year. Again, predominantly, marketing and engagement costs in California as we continue to promote the service, and that will skew some costs into the second half of the year. But nevertheless, we are confident that adjusted EBITDA for the full year will be comfortably in line with expectations.

7:48 At the full year results at the end of twenty three, we were we were guiding towards mid teens for an EBITDA margin for this year. We think that'll be sort of closer to 20% for the full year, and we expect to see that continuing into future years as well. Finally, our cash was just under 15,000,000 at the end of June. That's a strong position for us. A combination of the EBITDA and gross profit margins that we just talked about alongside some good working capital as well as we saw a little bit of we probably saw CapEx a little spent a little bit below where we were expecting for the first half as we started to hire products and engineer staff, but we'll see that catch up pretty much in the second half of the year.

8:35 So if I just to wrap up on financials, going through all of that, we're expecting to deliver some pretty strong adjusted EBITDA margins and EBITDA for the full year.

8:49 Right. So moving on. Let's just do a quick recap of why we're here, what problem we solve, the challenge that we're addressing, and then we go into each of those four areas that we've flagged a couple of slides ago to add a bit more context to that before handing over to q and a. So but poor mental health is one of the biggest challenges of our time right now. There is a growing crisis and a recognition of this, but more so than with young people. This report shows the impact over the last decade in The US on the degrading mental health of the population. Really incredible, sobering, stats for any parent, which is that twenty two percent of high school students seriously considered suicide, ten percent attempted one or more times.

9:42 And this is not just about dealing with issues for now. Seventy five percent of life or mental health conditions are established by age 25. If we don't help people right now, we're dealing with a population and a generation with poor mental health for life. And so that's why we're here, but it's also that you cannot freak your way out of this problem. In The UK, over one million children and young people sought help from the NHS in the last year. That's a 53% increase in the last five years. And NHS trusts over 80% in a report that they cannot keep up with this growing level of demand. It's simply unsustainable.

10:28 That's despite £2,300,000,000 being put in over the last five years. We have to take a different approach to this. We can't let people get to a point of severity where we try and treat them. And so our approach, like many things in health care, is prevention is better than cure. If we can reach you early and we can reach you before you get to the NHS or to your health care system, We can help give you the tools and support for good mental health for life. And so KOOTH PLC is really built on these three principles. Firstly, to reach youth where they are. They're in schools. They may be going to their physician or GP for first advice, and they're online on social media. They're searching on Google for where to get support will be found in each of those places.

11:18 Then we can support people if whether they've gone early need for help and some advice, whether we've got to keep them safe. And so this thriving framework in the middle here really informs and drives our product and our service. And finally, KOOTH is not a digital island. We are a digital front door into other health care services. So we can connect you into other services in the health care system if you need more help or connect you to crisis services if you need in the moment support. So this model is really focused on reaching people where they are, giving them support to reduce the demand, distress, and cost of downstream acute mental health care.

12:04 When you look at what that what usage of our service looks like, what's interesting is when you reach people early, 60% can get the support they need from our content, from our community that we offer. Of those that engage with a professional, the majority of them may get drop in support or single session therapy, and a small number will get longer support over six to 12 counseling sessions to really help them make a positive change in their life. So this model can scale up to population wide because we can provide a variety of tools and interventions and support options that can operate at a whole population. Thanks, Sim. So just a quick reminder for everyone as to how we how our business model actually works.

12:54 So, typically, we will initially sign a twelve month contract with the clients. It's a fixed contract, some paid monthly, usually monthly in advance or quarterly in advance. And we'll agree our value for that contract based on what we think usage of our service will be in that particular region or across that particular population, which might vary based on whether it's a rural area or an urban area, perhaps an area with a low or a high ethnic minority population. And once that fee has been agreed and we start mobilizing and launching in a particular region, what we're really aiming to do is to increase usage of our service. So we might expect one in forty young people, for example, to use a service in that specific region, we may have an ambition to try and get that number to, say, one thirty by the end of the twelve month pilot period.

13:46 We do that through two means. We have an engagement team. These are staff employed by KOOTH who are typically our feet on the streets. You know, they they spend a lot of time working with children. They might be ex teachers or ex social workers, for example, and they will be going into schools. In The UK, they'll be talking at school assemblies, encouraging kids to sign up to KOOTH, explain to them how the service works. Mhmm. They're sort of contemporaries in The US. They run school workshops, for example, and, you know, that that that approach, you know, works very well in specific regions. With somewhat with an area like California, which is obviously a huge state, we also supplement that with some specifically targeted social media campaigns and digital marketing.

14:36 We might, for example, use micro influencers on Instagram or TikTok. And so those two mechanisms are really looking to push up awareness of KOOTH and usage of KOOTH, and we often see a snowball effect. Friends recommend us to eat to to to their other friends. So we we start to see usage increasing, and that gives us a great opportunity at the end of the contract to have a discussion with the clients about expanding the resourcing on the contracts and looking for a fee increase to cover that. Around 40% of our contracts last year increased at the time of renewal. And in addition to pushing up usage, we would also look to add additional age groups potentially. So if we start with eleven to eighteen year olds, we might

15:22 add nineteen to twenty five year olds, or as in this example here, where we then eventually added adults. So in this particular region, we were able to grow that contract over a number of years. The the the rates of revenue growth has been around 28 for the last five or six years, and that's a contract that is now worth over £2,000,000 in ARR. So a great example for us of a land and expand type model.

15:51 In addition to that ability for us to support on this seed and grow and land and expand model, just a reminder of what we're then providing. As you saw in the pyramid, by self guided tools, peer support, professional support, something we launched in the first half of the year, yeah, is care navigation in The US, which means that we can become a digital front door to all health and welfare services in The States. That means for an individual that we might be supporting, they may need some additional support with a

16:21 service for behavioral health issue, addiction, or possibly an eating disorder, or maybe even a homeless issue. And so there, we can connect them directly to other services, looking at their eligibility. We can then do the administrative work to get them an appointment in that service and make sure that happens. So in that way, we leave no one behind. Someone that comes for our service, we're gonna give them the support and care that they need, and we have a directory embedded within Soluna that spans the entire US and the available services there. So we think that's an incredibly powerful addition to our platform to make sure that we are working in an integrated way within the health and welfare systems within the state.

17:09 And, of course, of eek of equal importance to how we help and support individuals is how we can help and support health care systems who are struggling with growing costs and demand. And so health economic studies done by the York Health Economics Consortium looked at our UK service and found more than three x cost saving on public services by deploying keys in one region, whether that be through GPs,

17:40 hospitalization, and a reduction in self harm behavior. So we think that this combination of providing early help is beneficial to individuals and is also beneficial to public services and health care systems. And those really really is the north star by which we operate our organization is to have that win win essentially model in place. I'll just to go into some of the key updates in a bit more detail before we open it up to q and a. Obviously, we're really proud of the work that we've done with California, which doesn't simply just span the last year of our product development, but California themselves spent, several years working with young people, working with key experts and stakeholders to identify what is our digital strategy. What should it be? How are we going to turn the tide on this growing overall health crisis?

18:33 We're very benefit very grateful to be working with California to help execute and implement this digital strategy. And what we can see from the first six months is we're seeing usage across every one of California's 58 counties, incredibly positive feedback from those that engage with the service, 70% reporting a positive outcome from single session therapy, and 95% of service users would recommend us to a friend.

19:01 We're also tackling health inequality. More than half of the people that use Soluna are from the highest areas where there is health inequality. So making services more accessible to underserved and marginalized communities. And with the addition of care navigation now becoming a digital front door into local services that we can help individuals get the support they need.

19:27 In addition to that, a a month or so ago, we went live in Illinois with Aetna, which is one of the largest Medicaid managed service providers in The US. They operate in 16 states and are part of CVS Health Group, which is a $95,000,000,000 market cap company. The aim here is to start small, prove out our service, and then scale it up. And so what we're focused on over the next year is demonstrating that by providing this early help to a population of just over 10,000, we can reduce the demand for more downstream acute costly mental health care. That means a reduction in ER visits, a reduction in prescriptions, for example. So we need to run this for about a year so we can see the longitudinal study where people go once they've engaged with our service.

20:17 On the back of that, there's potential to scale it in Illinois, and then obviously in other states in partnership with Aetna. And looking at the big picture, Medicaid is a 30,000,000,000 a year spend already on

20:29 youth behavioral health. It's one of the largest items of government spending, and so we think that we can help tackle and improve access to mental health care and reduce the cost of doing so.

20:45 Regarding Pennsylvania, which those of you that have practiced for some time will know is our first pilot project. So we have run that we ran that for about a year to look at the impact that we can have. So we saw one in ten of the population using the service, high degree of positive feedback from students that felt that they got the support they needed, and great support from school administrators and school districts who saw this as a really additive part to their toolkit effectively for how they could improve student

21:17 mental health and student academic outcomes. We're really pleased to see the superintendent school dis the school district of Philadelphia give us a mention in their plan for the year of how they're gonna improve student support. And where we are now is we've agreed with the Department of Human Services, a funding award with an initial approach of funding. We are negotiating with remaining parties just to get to a final number of that contract award. Our ambition is to continue to serve everyone that has access to KOOTH already. And on the back of this, we would swap over our service, upgrade it to Soluna, really in line with our view that we wanna bring these new innovations everywhere we go.

22:07 Finally, in The US, we have been working for more than a year on expanding our services through partnerships with states, whether that be with the health care system or through the support of funding that's going in to tackle youth behavioral health, and we're really pleased to see that progressing. So through this pipeline that we've been on journey we've been on, we've looked at every state to identify ones that we should focus our energy into, hide lobbyists to help us open doors and share the work that we do, and then work through state budgeting process to come up with an award or an RFP that we can then respond to. So we're far enough along there that we are expecting two contracts to be signed by the end of the year. I should flag that they are pilot contracts, and so they fit in with their model that Sanjay mentioned where we seed and grow in the state so that we can improve our impact locally and then scale up.

23:04 And finally, bringing it back to The UK. Those of you that are in The UK, you will know that the NHS is going through one of its toughest times in its entire history. There is significant financial pressure. There is a £2,200,000,000 deficit predicted, which they need to close the gap on. And there are all time high waiting lists for elective care, which need to be addressed. And so this is creating a huge amount of headwind and pressure in the NHS, one that is really unsustainable, which is partly why in the last week, we've seen Lord Dazi's NHS investigation to look out what needs to change to really build an NHS fit for the next seventy five years.

23:52 And, really, the key outcomes from that are that there are three big shifts that the government intends to do, and they they shift from analog to digital, from treatment to prevention, and from giving care in hospitals to giving it within the communities. And so that shift, what we expect to see is that shift will manifest itself in a revised ten year plan for the NHS and then operating guidance that really helps direct the resources in different regions across England into those three priorities. So I would say to some degree, what we're seeing is continued financial pressure, but there are some green shoots on the horizon of a shift that really fits with what Kufa's been doing for over two decades.

24:43 To add to that, this report that was published a couple of months ago from the Tony Blair Institute for Global Change highlighted that if you're going to have prosperity, economic prosperity through health, then investing in prevention or mental health could

25:00 contribute around 7,000,000,000 a year by 2030. It could increase GDP by 0.3%. So our efforts right now are focused on advocacy and making sure that all of the good work that we do locally is known centrally to ensure that these incredible innovations and opportunities to take things that work in well can be scaled everywhere is really our focus. In addition, and then to support that, we are bringing Saloon to The UK next year in q two. And a north star for us and a continual focus for us is not just about providing those great therapeutic outcomes, but health economics is our north star north star, making sure we can support more people more economically to continue to scale this up to be a population wide service.

25:56 Great. Thanks, Tim. So, look. We're really excited about the next twelve to eighteen months building on the record results in the first half. We will continue to invest in the platform, people, and reach. A lot of that focus, as we've indicated, is going to be in The US, which is now more than 70% of our overall business. You know, into that, we have a strong pipeline in The US. As Tim indicated, taking us through the sort of the business development process, we're expecting to sign two pilot contracts this year and further contracts next year as well as starting to see outcomes from things like the Aetna Medicaid projects pilot. Sorry. The we we continue to see some headwinds in the NHS.

26:42 We think those will persist into the second half of this year, but with the launch of Saloona expected in the first half of next year, we think that will start to really reinvigorate our offering in The UK as well as things like the ten year the NHS ten year plan being announced in the first quarter of next year. So we're we're confident of meeting expectations for the full year. The business has been strongly profitable as you will see. We're starting to generate significant positive cash flow. So a good outlook for the remainder of the year. So we'll just open up to q and a, we've had some that come in. Just a brief recap on our investment case. We're tackling one of the world's biggest issues. There is a structural demand.

27:28 It's gonna take some time to turn this around, and really our focus is on helping turn the tide in this growing crisis. We've what really attracted both Sanjay and myself to KOOTH is the diligent work over decades to really bring a service to bear that can really substantially make an impact. And so we see that through the outcome measures that we have and through the feedback that we get from young people. We've got a business model built on recurring revenue, so that means we've got good visibility and that enables us to invest in the future in confidence. And we're just at the tip of the iceberg really of how we can help scale up both in The US, The UK, and internationally. And, obviously, internationally, we don't wanna overstretch ourselves, but we think the model there would be one way we would license our technology to local health care providers that can operate under their own brand in their own country.

28:22 And the the barriers to entry are that we are supporting vulnerable people. So trust really matters. Safety really matters, and quality is really matters. And so these are the things that we continue to invest in underpinned by more than 50 research studies and health economic outcomes that demonstrate that we do good, and we help individuals, and we help health care systems. So with that, I'll just pass that back and then we shall open it up for questions. Tim, Sanjay, thank you very much for your presentation this afternoon. Ladies and gentlemen, please do continue to submit your questions just by using the q and a tab situated on the top right hand corner of your screen. Just while the company take a few moments to review those questions submitted today, I'd like to remind you that recording of this presentation along with a copy of the slides and the public q and a can be accessed by our investor dashboard.

29:10 As you can see, we have received a number of questions throughout today's presentation. Could I please ask you to read out the questions and give responses where appropriate to do so, and I'll pick up from you at the end. Fantastic. Thank you for that. So let's start with the first question from Bruce. How did you develop the services which you currently offer? What is the focus of your future development likely to be? Is what is on offer in The US different to here in The UK? And if so, in what way? Thanks for your question, Bruce. So the the foundation of the services that we develop are really driven through two things. One, which is called an underpinning research model called a theory of change. The theory of change by which we have developed Soluna is to create what's called psychological flexibility in the population, what we might refer to as resilience. If we can help create a more resilient population, we can, in a way, immunize the population towards the challenges of life, the uncertainties that there are, and create a future ready population.

30:12 That has to be met buried though with the voice of young people directly. They need a seat at the table. They need to help shape and support and define our services. So over the last twelve to eighteen months, we've engaged with over 300 young people as we designed and conceived and developed Soluna. I can't emphasize that enough. The ability to co produce and co develop with young people is critical. And through doing so, we then want to have a balance of something that's as engaging as a consumer app as the clinical outcomes of a medical one without being over medicalized in and of itself. That's a real balance and something that we're we are always learning on, and it's never a finish line, but that's where we strive to develop.

30:59 On a more practical level, some of the capabilities that we are launching, we're just finishing up right now at the web version of So today, can access it as a mobile app through your smartphone. Not everyone has smartphones, or they might be locked as children so they can't install apps. So we're building the web version of Soluna. Beyond that, our roadmap is primarily complete in terms of the contract of commitments to California. And then I think we're looking at continually what kind of innovations we can add. The idea of growth group coaching, for example, or or, again, more innovation in outcome measures. In terms of the services we bring to The UK, we obviously want to make sure we develop this and deliver a service that is attuned to the local needs. And so the work that we're doing to bring saloon to The UK is is part working with young people to make sure that their their needs are reflected in our product, making sure our content is localized so you're hearing UK voices, not just American voices on that.

32:04 And then also working with UK commissioners. For example, there's a real focus in The UK on helping people that are sitting on waiting list to either give you support to take them off those waiting lists or stop them getting worse so that they can at least wait well. And so there will be some local differences, product capabilities that really connect into the local need that we see in The UK. And, of course, where we can, we can then bring those back into our global product. So next question from James. In addition to the two new contracts in '24, how many new US states do you expect to sign up for pilots in 2025? Sanjay, would you like to cover that one?

32:49 Yeah. Yeah. Absolutely. So we we talked through the effectively, the sales process that we run through in The US. We about a year ago, we engaged a couple of consulting groups to give us some advice across the whole of The US, identifying 10 to 15 states where we should initially focus our attentions. And, you know, we've seen the fruition of that, so we expect it by the end of the year with the two new states coming through with pilot contracts. State governments, the their financial year end is the June 30, so the budgeting process tends to take place around May, June, July of each year. And, you know, awards are then granted shortly thereafterwards or negotiated.

33:34 So I very much expect from, you know, the middle of next year, we will have very good visibility on what we're going to be potentially winning in the second half of next year. And we'd be disappointed if it wasn't at the same level, two pilot contracts that we're we're looking to sign this year. Right. We have the next question is how do you see growth in adult versus young people services in the next two to three years? So we've not spent really time on it in today's presentation, but we do have in The UK the service to adults. It's been tough in the last couple of years supporting that population, primarily as we rolled out new pilots and then with the financial pressures that there are on the NHS, that funding got diverted into more acute care.

34:19 But I think stepping backwards from that, if you look at the big picture and again the shift that the NHS has to make, it can't be that you need to be severely ill to get help. So we need to shift the the model of mental health care to be prevention and early help. Right now, there are many people on, millions of people on, they're unable to access support because they have not got to that threshold level of which they would qualify for a talking therapy as an adult. So I think for us, we are a pioneer. That means sometimes you've got to go first on that. We think we are the long term trajectory for support for adults must shift to early help, and we've got an incredible amount of proof points on that. So over the next two to three years, I think the trajectory for that in The UK will be shaped by the ten year plan that will come out next spring. And so it's incumbent on us to make sure that all the great work that we do is heard by everyone making decisions.

35:21 I'll take Ben's question. Yeah. So Ben has asked, besides The UK and US, are there any other geographies you are considering for expansion? How does competitive landscape vary between markets and how does it differentiate itself globally? So, certainly, it's always been on our roadmap to work internationally beyond The US and UK markets, although The US continues to represent tremendous opportunities for us, and we have great traction there as everyone knows. If we were looking across the rest of the world one one of the benefits of launching in California is that service is available in 19 languages, and there are 19 official state languages in California. So, of course, that gives us a good calling card into the rest of the non English speaking world.

36:08 But the form that I think our international expansion will take and, you know, we've had some preliminary conversations would be more of a licensing of our technology or working with a local health care provider who would perhaps provide the practitioner or counselor coach support operating through the what would be the Soluna platform. And let's say, we we've had preliminary sort of soundings out from state governments across the world with, you know, in Europe as well as places like South America and Asia. So it it's it's not something you could expect to see from us in the next six months, but certainly within the next eighteen months, I would be expecting us to see at least one contract of that nature.

36:55 In terms of the competitive landscape globally, we we believe that we are the largest provider of mental health services to young people across the world. We tend not to see a competitor doing what we do. They either fall into the camp of being very focused on providing counseling services or perhaps at the much earlier stage, you know, things like meditation apps, for example, well-being apps. So to cover the three or four pillars of KOOTH, which is, you know, the sort of self help community as well as professional support. That that's not a model that we've seen replicated anywhere else at this point in time. Unless Tim, you can think of No. I mean, that's a good summary of that. Couple more questions.

37:44 So, David, you're asking the interim report suggests the number of service user logins has been flat What's behind that? So I I can answer that. There's a couple of reasons. One is obviously some contract losses. So when we lose contract, we lose the local population. But the other part to that is when we are engaged with a commissioner to review their usage and build the business case for expanding. Where they can't fund that, and it's certainly been tough in the last year, we will dial back on promotions so that we can really stay within the contracted amount. The reason why we do that is if we continue to drive more usage and more awareness to the service, and we haven't hired more practitioners at the back end of that to support that contract, we're just gonna see people wait longer.

38:30 And so we really make sure that we are trying to balance effectively the amount of promotion that we're doing with the expansion that we're doing within our current accounts. Following the last couple of questions, perhaps, Sanjay, you could talk about how the democrat versus republican administration is gonna impact our outlook. Yep. So, like I said, just ask how do we view a democrat versus republican administration. So there's a relatively simple answer, which is we operate at a state government level across The US or at the sort of insurer level. So the I'd like to say that the federal elections do not have a significant impact on the work that we're doing across The US unless, for example, the administration was to decide to remove Medicaid, but we that seems to be pretty unlikely.

39:24 So at a federal level, there shouldn't be a significant impact on the work we're doing. But at the same time as the elections in November for for the presidential elections, there are a number of more local elections as well, things like state senates and state house of representatives, and that does have more of an impact on the work that we're doing. One of the learnings we've taken from Pennsylvania, which is a swing state, is that where you have a bipartisan administration, it does slow down decision making. So, you know, the negotiations are taking place with twice as many parties essentially as perhaps in a stronger republic or or a democratic local administration. So but that that has been a learning for us. We're tending now to focus on non swing states, but we don't expect the federal elections to be significantly impactful.

40:19 Right. Just two final quick ones, and we'll wrap up. First thing is a question from James about the view of of potential upgrades of the product perhaps driven by AI. Very timely. I'm not gonna answer the question directly now because I'm gonna spoil my own thunder otherwise. I'm attending the UN general assembly in New York next week. I've been invited to talk on the topic of youth behavioral health, how we're gonna turn the tide on this, and how technology is gonna help. And as part of that next week, we aim to publish our public position on AI and how it will help. So watch my LinkedIn feed if you like more detail on that. And then perhaps the other part to the final question, which is Bruce, you're asking a huge question, which is can you explain what what's driving the increase in mental health issues along young people here in The UK and elsewhere?

41:10 So I could spend an hour on this, but I think if you were to prioritize a number of things, we know the toxic impact of social media has had a has had a degrading effect on youth mental health. We also know health inequality has a has an impact on them, which we've seen over the last few years. And look, we're in a world which has incredible change and uncertainty on it, whether it be the climate crisis, whether it be that you've got a you've got a degree but you can't get a job, whether you're on zero hours, whether you feel that you are essentially living a life without hope or control. Those are two things that we all need to really build our self confidence and maintain that. And so I think it's a war a sign that, you know, they started to really accelerate over a decade ago. This is not simply a pandemic problem.

42:03 This is really one societal problem that I think you could see many organizations start to look at how they can address root causes. But those root causes include the needs for everyone to have opportunity to address poverty and really to ensure that we can keep a healthy nation. And so there are a lot of things driving this. And, of course, if we can help build that psychological flexibility, we can help build a more resilient population to deal with all these uncertainties. So with that, well, thank you for your questions and answers. I'll just hand that back, and we'll do a final wrap up. Tim, Sanjay, thanks for answering all those questions you care from investors. And, of course, the company can review all questions submitted today, and we'll publish those responses on the investor meet company platform. Just before redirecting investors to provide you with their feedback, which I know is particularly important to the company, Tim, could I please just ask you for a few closing comments?

42:55 Well, thank you for joining us today. We know we've taken quite an abundance of your time to take you through the whole story of KOOTH and our h one highlights. I hope you've seen in what we're doing both the importance of the purpose of how we've got and the fact that we can demonstrate with me a public company doing that. I think what excites us is this blend of both of these things. So your support as shareholders really makes this possible. And I think to create an ecosystem of the future that can help tackle the health and challenges that we as a nation have and drive economic growth by exporting is a wonderful model and something that we are personally championing in. So thank you for your support. Tim, Sanjay, thank you for updating investors today. Now please ask investors not to close this session as you'll now be automatically redirected to provide your feedback in order that the management team can better understand your views and expectations.

43:48 This will only take a few moments to complete, and I'm sure will be greatly valued by the company. On behalf of the management team of KOOTH PLC, we'd like to thank you for attending today's presentation, and good afternoon to you all.