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Oxford Population Health researchers, in part supported by the ARC OxTV, are leading a cost-effectiveness analysis of a new online, parent-led intervention for young children at risk of anxiety disorders.


Anxiety disorders are the most common mental health disorders experienced across the lifespan, with half of all lifetime cases beginning before the age of eleven. Children who suffer from anxiety disorders are more likely than their peers to experience ongoing anxiety problems throughout life; develop other serious mental health disorders; and have reduced educational and employment opportunities. Yet only a minority of these children are able to access specialist mental health treatment, making it more likely they will require specialist support later on.

Minimising Young Children’s Anxiety through Schools (MY-CATS), a randomised controlled trial led by the University of Oxford, is investigating whether an online programme delivered by parents and carers could be one approach to help increase access to mental health support. The programme, called OSI (Online Support and Intervention for child anxiety), is being tested on children aged between four and seven who are identified as at risk for anxiety problems through screening in primary schools. A full protocol of the study methods has been published today in Trials.

Participating schools are randomly allocated to offer children identified as at-risk for anxiety disorders and their parents/carers either the usual social, emotional and mental health support they provide, or OSI in addition to usual support. The OSI programme involves seven online modules, weekly telephone consultations with a trained children’s wellbeing practitioner, and an optional App that uses a game to encourage children to face their fears. The modules teach parents evidence-based strategies to help prevent and manage child anxiety problems, including promoting independence, fear testing, and problem solving.

The study launched last year and so far almost 600 families from 60 infant/primary schools across England are taking part. Ultimately, the study team hope to involve up to 90 schools and about 900 families in total. Parents of all children in participating reception, year 1 and year 2 classes are invited to complete questionnaires about how much their child experiences anxiety and shyness, and about their own anxiety. Families of children with elevated scores on one or more questionnaire are invited to join the MY-CATS study, however they are not obliged to.

The study will mainly assess the absence or presence of an anxiety disorder diagnosis after 12 months, however the researchers also intend to investigate the characteristics of children who benefit most from OSI, and how parents/carers, children, and school staff experience the programme.

Associate Professor Mara Violato from the Health Economics Research Centre at Oxford Population Health, will also lead a cost-effectiveness analysis of the OSI intervention. This will include both individual and broader societal measures, including health-related quality of life for both children and parents, use of mental health services, time off school for children, productivity losses for parents, and the costs to run the OSI programme.  

Associate Professor Violato said: ‘If effective, and representing good value for money, we hope that MY-CATS will not only advance knowledge about risks for child anxiety disorders and their underlying mechanisms, but also influence health policy and practice by informing prevention and early intervention programmes. The results could also provide the basis for a wider model for identification and intervention that can be expanded to other common mental health conditions in children and to other international settings.’

Find out more about the study, and how schools can take part on the MY-CATS website.

The MY-CATS study is funded by the Kavli Trust and the NIHR Oxford Health Biomedical Research Centre.

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