For parents worried about a child’s anxiety, the hardest step is often the first one: finding out where to go for help. In Iceland, that barrier has been largely removed, after the country became one of the first in the world to roll out a national, self-referral digital mental health service for children as young as five.
The programme, known as Online Support and Intervention for Child Anxiety, or OSI, allows parents of children aged five to twelve to seek support directly online, without needing a referral from a doctor or school first. It was originally developed in the UK before being translated and adapted for Icelandic primary care.
Since launching in September 2025, the service has already reached hundreds of families. By May 2026, 380 families had self-referred, and 342 of them, around ninety per cent, screened above the clinical threshold for probable anxiety. Of those, 204 families, or sixty per cent, went on to start the intervention proper.
Researchers behind the rollout, writing in the journal Child and Adolescent Mental Health, say referrals surged by seventy per cent over six months, driven by growing awareness among families and expanding clinical capacity. They argue this shows self-referral can reach children with genuine, clinically significant anxiety difficulties without the usual professional gatekeeping.
What makes the Icelandic model notable is not just its accessibility but how it is delivered. Parents complete a brief two item screening questionnaire online, then, depending on the result, are offered a short call with a clinical psychologist based in primary care. This keeps clinical oversight in place while cutting down the number of appointments families must navigate before support actually begins.
The service is also embedded within Iceland’s existing primary care system rather than run as a standalone app or platform. Clinical psychologists already work within primary care there, so the digital programme slots into a service families already recognise and trust, rather than feeling like a separate, unfamiliar product.
Crucially, the researchers stress that scaling a digital mental health service nationally is far from simple. Iceland’s rollout required cooperation across seven different health institutions, each with its own governance and working practices, alongside investment in technical infrastructure, cybersecurity, staff training and data protection.
The authors caution that Iceland’s approach cannot simply be copied wholesale elsewhere, since healthcare systems vary widely in funding, regulation and workforce structure. But they believe the underlying principles, simple self-referral, integration into routine care, and close collaboration between clinical and technical teams, could offer useful lessons for other countries exploring digital mental health support for children.
The findings arrive at a time when demand for child and adolescent mental health support continues to outstrip capacity in many countries, including the UK. As services look for ways to widen access without compromising clinical safety, Iceland’s experience suggests that how a digital intervention is implemented may matter just as much as the technology itself.
