Enabling Child and Adolescent Mental Health Services (CAMHS) to provide efficient remote treatment for child anxiety problems in the COVID-19 context

NHS Child and Adolescent Mental Health Services (CAMHS) currently face major challenges in providing psychological treatments that (i) work when delivered remotely, and (ii) can be delivered efficiently to manage an anticipated increase in referrals as social distancing measures are relaxed.
Anxiety problems are a common reason for referral to CAMHS, children with pre-existing anxiety problems are particulary vulnerable in the context of COVID-19, and there are concerns about likely increases in childhood anxiety as schools reopen.
We worked with children, parents and NHS clinicians to develop an online program (OSI) that parents/carers of children with anxiety disorders work through with remote support from a CAMHS clinician. We will now test whether OSI works as well as what CAMHS are currently offering to help children with anxiety problems (while social distancing measures are in place and in the post COVID-19 recovery phase), and whether OSI brings wider benefits to families and CAMHS. We will also provide an understanding of parents' and clinicians' experiences of digital treatments in CAMHS in the context of COVID-19.
This research has the potential to create a step change in the digital delivery of treatments in CAMHS, bringing benefits in the COVID-19 context and beyond.

This proposal addresses the need for evaluation of innovations in health and social care delivery prompted by the pandemic which can be generalised and actioned in the pandemic context. Specifically this proposal sets out to mitigate the impact of the COVID- 19 outbreak on children, families and Child and Adolescent Mental Health Services (CAMHS) by evaluating an innovative, potentially cost-effective, digital intervention for child anxiety problems.
The focus is on child anxiety problems because (i) they are the most common mental health problem across the lifespan, (ii) they typically first occur in childhood and are a common reason for referral to CAMHS, (iii) fears, worries, and anxieties have been fuelled by the current context which has increased perceptions of threat and uncertainty, and (iv) CAMHS have identified children with anxiety problems as a key risk group in the context of COVID-19- both during lockdown and as social distancing measures are relaxed.
We will conduct a multi-site randomised non-inferiority trial to establish whether a novel online, parent-led cognitive behavior therapy program (OSI; Online Support and Intervention for child anxiety) is as effective as what CAMHS are currently delivering in the COVID-19 context, and whether it brings health-economic benefits.
This research has the potential to provide (i) a solution for efficient psychological treatment for child anxiety disorders while social distancing, (ii) an efficient means of treatment delivery to manage the anticipated increase in CAMHS referrals when social distancing measures are relaxed and schools reopen, and will (iii) pave the way for high quality, efficient evaluation and implementation of digital solutions in CAMHS.