Article about fabricated or induced illness

[DianaVilliers]

Did anyone read that article in the Times recently about the rise in false accusations of fabricated or induced illness against parents of ill or disabled children? The article is behind a paywall but this has a summary of it. https://www.lancashire.ac.uk/news/fii-serious-case-review
And Cerebra did a study into Fii a couple of years ago. cerebra.org.uk/research/fabricated-or-induced-illness-research-report/
Apparently at least half of these accusations are made by professionals after parents have raised concerns about poor care their child is receiving.
Am I being unreasonable to think that true fabricated/induced illness is very rare and the majority of accusations are likely either being used to deflect blame from failings in the NHS, or just professionals jumping on the latest moral panic bandwagon a bit like the satanic panic of the 90s?

It really is a good description, indeed.

Even if you aren’t considered uncooperative or hostile they then label it as disguised compliance. You can’t win. If you complain about false allegations or inaccurate opinion being presented as fact and try to provide evidence to counter this you are labelled an attention seeker which is apparently a further red flag/symptom of FII. It’s really hard to navigate once accused.

I have not experienced this but I live in dread that I could do some day. Is there any way to reduce the odds of it happening, while still advocating for your child?

I suspect this reflects an increase in incidents of fabricated illness.

It's similar to dru seeking patients. When you see an increase in drug seeking patients, the impact spreads, because doctors have to become vigilant and start to question all patients who are showing behaviour which could be drug seeking.

It's not simple to tell, drug seeking works because drug seekers mimic reasonable and normal behaviours. And when they are denied they are not above using accusations to manipulate health care professionals.

In the past I think fabricated illness was more rare, but it now comes with a lot more "benefits" for the kind of people who want to work those. Maybe social funding, maybe time off work, maybe social media likes or followers, Some people are motivated to scam for these things in other ways, even putting huge amounts of effort for what seems like unimportant things like social media. So it shouldn't be a big surprise that it's increased, and therefor more suspicion falls on parents in general.

Keep all letters, test results, emails etc. if you have meetings at school/hospital with anyone who seems hostile or disbelieving - record them (this is allowed if it’s just for your own records if you need to use them as evidence at some point you have to transcribe them)

https://www.specialneedsjungle.com/parallels-subpostmasters-scandal-institutional-gaslighting-send-parent-carers/

Not sure if this might be helpful to some in the context of the conversation.

I think you’re very wrong and you are clearly not across any research on this. Might it be possible that you go off to the Style section or somewhere you might be more clued up?

Do you not think it’s a sign of the times where those in a position of authority are being found more and more to be gaslighting those they should be supporting, and immediately reaching for a simple yet devastating solution that makes their job much easier?

See also medical misogyny and the huge numbers of women fobbed off for years instead of a dr, you know, listening to them?

Gaslighting SEND parents is sadly a typical experience from teachers, social workers, CAMHS, drs. Accusing FII is an easy step forward from that.

I've recently had my kids school start trying to insinuate this. They said I've traumatized my child (but offered no explanation as to how, exactly) and that my mental health was the cause of them suffering from emotionally based school avoidance. They didn't say it outright, but it's certainly where they are heading with it. The school was the ones who negatively affected my mental health by bullying me and discriminating against my child.

Rather than school accepting that maybe I'm right, and my child does have autism and SEN needs - because then they'd have to do something to meet those needs - it's far easier to pathologise the parent. The lack of support for their autism is the beginning, middle and end of the reasons for their EBSA.

As an autistic parent myself, i feel incredibly vulnerable against this rhetoric as other autistic parents have been investigated and even had children removed once accused of this - I'm on the brink of deregistering and home educating rather than lay us open to that possibility again.

Thank you. Interesting article. Know of two families of disabled children who have been accused of this.

@Confuuzed That's awful I'm so sorry 💐

I think its's quite common.

My SD has been convinced from a very young age that she's a sickly child, despite being healthy as a horse. Every sneeze or ache and pain warrants a doctor's appointment and an insistence of referral to a specialist who inevitably says she's got nothing wrong with her. When her Mum brought her us and went over all the Holland and Barrett lotions and potions for her many ailments, DH would quietly put them to one side and hand them back at the end of the visit unused. She managed to get DLA and a +1 Nimbus card for ADHD (which she definitely does have, but they considerably exaggerate how it affects her) and thinks they can claim PIP next year. This is a very capable child who hikes and goes camping with friends, performs on stage, has multiple hobbies and does well at school, travels alone, and yet they are trying to work out how to twist this to say she needs support, beyond her ADHD meds and ordinary parenting.

My SIL is a much more sinister character and effectively coached her son to act more autistic (he probably is autistic but nowhere near as high needs as she made him appear) so she could get a diagnosis and money. She then co-opted her entire identity to "autism mummy." Social Services has been involved for a while and about six months ago said that due to various incidents that happened he now needed to live with his Dad and have supervised contact with her. She couldn't claim all the money any more so she left him with his Dad and disappeared, she's not seen him since.

Those are just the closest two examples I can think of.

Christ, someone needs to go tell the experts there’s a poster on mumsnet who says they are wrong. They are of the opinion it’s very rare. I think they are always recruiting more experts in consultant psychiatrist type roles if you are free?

The definition of rare is subjective and the above two cases won't even factor into statistics as no professionals have picked up on it as being fabricated illness. It has to get to quite a severe level before it's noticed. It's also entirely possible that I'm an outlier, but as I said, I have seen multiple cases of mothers (I'm sure it's sometimes fathers but I've only ever seen mothers) exaggerating or inventing symptoms in their children- whether it's out of genuine anxiety or just a desire for attention I can't say. I've also seen a few times people exaggerating problems their child has and gaining financially from it.

I've never seen any myself, and I worked with children and families for a long time. I've known a few new first time mums get a bit anxious about their babies health but that's perfectly natural and it's a completely different thing, fabricated or induced illness is someone lying about an illness or deliberately inducing an illness. All the evidence available points to it being a rare occurrence.

The “definition of rare” is not that subjective when the professionals have defined a percentage. It’s a very teeny teeny percentage of the population, most of whom are apparently known to you.

As pp mentioned, it’s happening up and down the country to parents with children who have ME/CFS and Long Covid, as there are no definitive bio medical markers to diagnose these conditions. A lot of doctors seem to psychologise any condition they can’t diagnose. ME/CFS has been psychologised for the past 50 years (and mainly affects women).

FII markers include parents pushing for second opinions or further investigations, so any parent who is considered a bit of a nuisance can be flagged up. If, for example, they don’t accept “your child is just anxious and doesn’t want to go to school” when the child can barely walk, but all blood tests are ok, the parents can be viewed suspiciously for questioning this diagnosis.

It also includes parents speaking on behalf of children or children looking to parents to speak for them, as is often the case for ME and Long Covid sufferers who are too fatigued to speak.

It shouldn’t be necessary but I think one of the best ways to avoid this is to always attend any medical appointments with the father of the child, or failing that, another male adult. Sadly, the whole institution is steeped in misogyny and ego.

Also, keep paper trails and familiarise yourself with NICE guidelines.

I have name changed - i work with children and families. I currently work with one family with a “perplexing presentation” (the level before it is judged to be FII).
i also have myself 3 children, all SENs. When DC1 was in primary the sendco made allegations of DV in the family (because they did not understand ADHD) and also referred us to social care (which turned out a positive thing in our case as they ended up advocating for us/our DC!) - Just to say i am not a cold hearted childless professional (like i have been told a few times!!).
Anyway, before making raising concerns of perplexing presentation (or PP), there is a very long winded process where as a professional you have to demonstrate harm done. This is easier when it is something concrete ie: tempering with stool sample etc… this is a lot harder when it is about emotional harm. The easiest thing to do is to collate a timeline of all medical/psychological interventions (this is a very time consuming job!) and of all the diagnosis. Then a “health professional” panel will look at it line by line and assess things like: “would this incident be age appropriate” “what was the outcome of the assessment? “ “when was the last prescription issued” “is there a reason why this is still prescribed” “why this medication is still prescribed” “why is this professional mentionning a xxx diagnosis ?”
As per the RPCPH guidance, parents need to be informed if health professionals are concerned about PP (but parents are not allowed to attend those meetings).
all information is cross referenced, the safeguarding lead of every institutions that has been in contact with the child is contacted to conduct their own investigation.
when all the information has been checked and collated, the health professionals can recommend that social care does their own investigation and only social care can move the diagnosis from PP to FII.
About benefits (such as a larger accomodations or benefeits payments), they are investigated to ascertain whether they were obtained through an unhelpful narrative and co-construction of illness, then a note is made but these benefits are not taken away (it would cause more harm than good).
if social care finds that there is no FII, we can still work with the PP diagnosis. If FII is found then CP Plan and Adult mental health can get involved.
so actually FII diagnosis are extremely rare. But i do agree the whole process can be very damaging. Ultimately we have to think evey step of the way, how can we help this family, why is this happening, how can we help the child(ren).
what makes PP/FII tricky is that there is always a legitimate need but the narrative constructed around is unhelpful. This is not something that can be resolved rationally with the parent in a couple of meetings

Also as a professional i do see lots of parents saying their kids have a diagnosis. It is important for is to have a copy of that letter so children can assess higher level of support (ie. DSR database). Sometimes records on the system are incomplete. We get that saying your chikd has an uatism diagnosis can be helpful in school and we are happy to work with school to think about accomodations. The children we see often have real difficulties and whether or not they have a diagnosis is not always relevant, they can still get a lot of support especially in primary school. But if we feel the parent is developing a narrative that pathologise the child, then that is when we will start asking questions, wanting to see the evidence. But that doesnt mean we are thinking perplexing Presentation right away. I have a case at the moment when an ASD diagnosis is put forawrd but it doesnt exist. We work witth that. There is no question in my mind about a perplexing presentation. We are working with the parent and school to get an EHCP instead. (Ie. We are not blaming the parent for “lying” about a diagnosis, we are working to get the right support for the child)

This is absolutely correct-and after our accusations we from that point on decided only DH would attend any medical appointments etc.

EDS is one that has a high rate of FII accusation. I can't find the research but there was an article about this a number of years ago. In fact I know a professional who was involved in such a case.

Here is the official guidance explaining the process in much better terms than i did! https://childprotection.rcpch.ac.uk/resources/perplexing-presentations-and-fii/

My son had a NHS diagnosis of dyspraxia at 6. Confirmed by a NHS consultant working privately in Harley street. My LA still said I was lieing trying to get him.a EHCP at tribunal.

My other son was completely non verbal until age 7. Mil told the health visitor he was fine and I was a worrier when he was aged 3. He passed his 3 year check with flying colours. He did not talk at all until age 7. So he certainly wasn't talking during his health visitor check. She didn't hear him talk and still didn't belive her own ears.

The gaslighting is real. Unless your pretty thick skinned it's hard to stand up to.

I had to ask in tribunal where the LA rep had got their medical degree from that it countered two separate NHS consultants. I.e point out he is very clearly totally batshit crazy to shut him up. He did it as he knows its very standard to call mums crazy and not get called out for. Only when I robustly pointed out he was as thick as shit in front of a judge did he drop it.

It's normally mums too. Us hysterical woman. Don't see dad's get accused as much but that does happen too.

@TempestTost and @proname aren't saying the rest of you are wrong, by my reading. Tempest says that as genuine cases rise, so too will incorrect accusations.

Many many parents struggle to get the support the family and child need.
There are also some whose anxiety leads them to believe the child has needs that aren’t seen by professionals involved.

I think there are several things true at once, as the saying goes. The original point raised in the article that parents who accuse the NHS of failing to support them appropriately do get accused in return, that actual case and false accusations are rising and so on. And that there’s an increase in poorly understood health conditions in the population.

ETA but I have felt really sad at the distressing treatment you have all received. I believe you.

You know they don't just hand out DLA/PIP on a parents say so?
You need evidence of the child/ young adults needs from professionals.

https://sunshine-support.org/fii-when-professionals-fabricate-the-truth/ Interesting blog post. "Professionals who typically do not have the expertise or skill set to help with complex presentations or hidden disabilities, unfortunately really struggle to fill the gap in their knowledge of these areas of specialism. Rather than researching, they can often fill the gaps in their knowledge with alarming made-up stories of child abuse that can prove hugely traumatising to read. The consequences of said reports can lead to very traumatising experiences for the family."