Online trend glamorizing psychiatric hospitalization seen affecting youth

 Mental health professionals are concerned about the consequences of a new online trend popular among youth. 

The recently popularized term is “grippy sock vacation,” mostly prevalent on social media. It comes from the non-skid socks given during psychiatric hospitalization when a patient’s laced shoes are confiscated for their safety. Providers worry the terminology may play down mental health treatment, contribute to stigma and sensationalize psychiatric hospitalization.

It was first searched online in the U.S. in September 2021, according to Google Trends, with searches peaking that winter at 100 hits. On Facebook, the first public post using the term was Oct. 1, 2021, according to CrowdTangle data, by a user with 193,000 followers whose page identifies them as a comedian. In their Twitter bio, their location is set to “grippy socks palace.” Their post was also made into a meme and reposted by several accounts. In total, 25 posts amassed more than 19,000 interactions. Countless public tweets also mention the term. 

“There’s a whole slew of TikTok videos with this hashtag,” says Suzanne Sampang, M.D., clinical medical director of child and adolescent psychiatry at Cincinnati Children's Hospital Medical Center. She said some make fun of their own experience or try to explain what it was like, while others joke about or glorify needing to be hospitalized due to the stress in their life. Sampang has lots of conversations about TikTok trends with her patients, and, while they have not specifically brought up encountering this one, she doesn’t doubt they have been exposed to it. “Like everything TikTok, there’s some positive and some negative,” Sampang noted. 

Importance of evaluation

Psychiatric hospitalization is the highest level of care for someone in crisis who is usually at imminent risk of harming themselves or others, providers say. 

“Equating psychiatric hospitalization with a vacation really trivializes what is really a serious health need that requires a hospital stay,” Sampang said. This is especially worrisome amid the growing mental health crisis among minors.

“It can be a sanctuary for people that need it most,” said Paul Weigle, M.D., chair of the American Academy of Child and Adolescent Psychiatry’s media committee and a child and adolescent psychiatrist. For some, inpatient treatment can be a way of avoiding stresses in their life rather than dealing with them. 

“In most cases, it’s best to face the situations that give us stress rather than trying to avoid them,” Weigle said. “Avoiding them can actually make the anxiety worse.” 

Or, teenagers who are exploring various identities in young adulthood may try to identify with a mentally ill person, especially if someone they love has been a patient. “That’s oftentimes not the way we want kids to see themselves and each other – just about weakness. We want them to identify with their strengths,” Weigle said.

One concern is that youth can lie about or exaggerate symptoms in order to get admitted. In fact, this practice is not new, said Dale Peeples, M.D., a child and adolescent psychiatrist at the Medical College of Georgia who said he has worked in inpatient services for two decades. However, the internet may now be facilitating tips and tricks among those who want a successful hospitalization.

“We are seeing a lot more psychiatric presentations that would not fit the typical clinical picture we’d expect,” Peeples said. In the past two years, the number of patients presenting with what they believe to be tics or dissociative identity disorder has shot up, even though most do not qualify for a diagnosis, he said. (TikTok tics are another viral trend that has affected children.)

Weigle agreed, saying in his experience at a partial hospitalization program for youth, most who want an inpatient admission do not meet the bar for it.

The job of mental health professionals is to get the whole picture before determining whether a presenting patient meets the bar for inpatient admission. That could include talking to parents or caretakers and other healthcare workers. However, “when in doubt, we always want to err on the side of safety” and believe patients, Weigle said. 

Potential alternatives 

If a presenting child can be kept safely at home, that will usually be better for them, Weigle said. Supplemental approaches to staying at home could include seeing a therapist more often, checking in with the child's school’s staff and eliminating dangerous objects in the home. But if parents are concerned about their ability to maintain their child’s safety, they should get them evaluated. 

Providers should maintain an open mind and get to know their patients to understand what is motivating them. They can ask them what they saw online and how it affected them. They could also talk to their parents about it. Ideally, parents should be involved in their kids’ online lives to an extent, but the amount of monitoring will depend on the child and where they are developmentally, providers said. For instance, a younger child may need more supervision.

Partial hospitalization or intensive outpatient programs may also be alternatives to a full psychiatric hospitalization. Finally, community support and a daily routine are critical.

“There's no replacing family and friends, sports teams, supportive schools and all that,” Peeples said. 

https://www.fiercehealthcare.com/providers/online-trend-among-youth-has-mental-health-providers-concerned