Fabricated or Induced Illness Research Report

14 November 2023

The findings of a major research project concerning the prevalence and impact of allegations of FII has been published today. FII is a term adopted by the Royal College of Paediatrics and Child Health (RCHP) to replace ‘Munchausen syndrome by proxy’.

Fabricated or Induced Illness Research Report

14 November 2023

The findings of a major research project concerning the prevalence and impact of allegations of FII has been published today. FII is a term adopted by the Royal College of Paediatrics and Child Health (RCHP) to replace ‘Munchausen syndrome by proxy’.

Family with siblings

The findings of a major research project concerning FII have been published today. This research report considers the prevalence and impact on families in England, Scotland and Wales of being accused of creating or exaggerating their child’s difficulties – an extreme form of parent carer blame. Instances of this kind are referred to as ‘Fabricated or Induced Illness’ (FII).

A parent interviewed describes how she was accused of FII. She was providing medication for her disabled daughter on the instructions of hospital doctors. A doctor at a different hospital disagreed alleging that she was “killing” her child and that if she didn’t stop the medication, she’d “go to social services, and get her taken off me”.

After the medication was removed her mum says she is haunted at the memory of watching her daughter apparently in pain. “She would give us this look, begging me to help her, and I couldn’t. We had to just sit there and watch.”

The Report’s ‘Key Messages’

  • The major finding of the research is one of family trauma. The making of an FII allegation often causes devastating and life-long trauma to those accused and to their children.
  • FII allegations against parents of disabled children appear to be widespread and increasing. Parents in at least 74% of English children’s services authorities have experienced FII allegations – and authorities in Scotland and Wales were also reported as initiating allegations of this nature.
  • Disabled parents appear to be four times more likely to be accused of FII than non-disabled parents – suggesting a significant risk of widespread unlawful discrimination against disabled people.
  • 50% of allegations of FII were made after a parent carer had complained about the actions of the relevant public body.
  • Most FII allegations (84%) resulted in no follow up-action or were abandoned and in 95% of the cases the child(ren) remained living with the parent.
  • Royal College of Paediatrics and Child Health (RCPCH) 2021 FII guidance is likely to give rise to a very high number of ‘false positives’ (people being wrongly accused of FII).
  • NHS practitioners were the source of most FII allegations, followed by schools and then local authority children’s services.

Launching the report, Professor Luke Clements said:
“The evidence suggests a significant increase in the numbers of parents – especially disabled parents – being inappropriately accused of FII. These allegations have a devastating and often life-long impact on families – including their children: the very people the system is supposed to protect. There is an urgent need for a radical overhaul of policy and practice in this field”.

The research report calls for:

Urgent revision to the RCPCH (2021) FII guidance including:

(1) to address its failure to recognise the harm to parents and children caused by allegations of FII

(2) to address the danger that its ‘alerting signs’ may have an unlawful discriminatory impact on disabled parents

(3) to acknowledge that its ‘alerting signs’ (of FII) are unsupported by any peer reviewed research.

The full report can be downloaded here.


The report is based on research undertaken by the Cerebra Legal Entitlements and Problem-solving (LEaP) Project based at the School of Law, Leeds University.

The research involved an analysis of data obtained from a survey of 387 parent carers, freedom of information requests and on-line searches of local authority websites.


10 thoughts on “Fabricated or Induced Illness Research Report”

  1. Vicci Holbrook-Hughes

    This is not just about the wrongful accusations, it also means that there is a serious risk of health and other services actually withholding treatment and/or not diagnosing children correctly thus compounding the discrimination, the principle of ‘act or omission’ would seem to apply.

    1. Hi Vicci
      This is exactly what has happened and still happening to my daughter. Almost 5 years ago she contracted the Flu, since then she has never been the same mentally and physically. It’s such a long painful story that I’m still going through 5 years on, with my daughter now 17, she has very delayed speech and lacks understanding, has Autism, ADHD, Tourettes, severe sensory needs, OCD, etc, she is unable to express pain or tell anyone what is happening to her body. Her life has been non existent since the Flu, the school, the LA, my local NHS hospital, Great Ormond Street hospital, and now the ICB have all accused me of FII, trying to diagnose my daughter and medicalise her. As a result I’ve been in care proceedings twice, a few months ago the LA tried to remove my child from me, but thankfully failed thanks to CAfcass who we met a few times, which says it all. Due to being accused of FII constantly, it was only when I entered into the first care proceedings in 2021 that the court appointed experts said mum should be listened to and tests need to be carried out on my daughter. I eventually got tests done last year for her, with some results needing further investigation, but the NHS Paediatrician wouldnt do anymore tests and put it down to her Autism and behaviours. Because the Paediatrician said this, everytime I tried to seek further help, I got further accused, I eventually paid privately and got a very different response, to the point of some diagnosis, which included probable seizures. Even with these diagnosis the LA still failed to recognise something was more wrong, when I got referred to GOSH via my private Neurologist, they turned against me after listening to the LA saying I was trying to diagnose my daughter, with this GOSH then raised FII, failed to carry out any tests and dismissed us saying it’s just behaviour. I still continue to be accused due to both Paediatricians saying it’s just Autism & behaviours. My daughter has been on a child protection for over 3 years straight, with absolutely no help at all, just constant lies & false accusations. Due to the LA being threatened with the high court on education, the ICB has now come out of the woodwork and as an interested party, their now accusing me of FII, based on wrong information with them even presuming my daughter had capacity, due to there being no MCA on file, as the LA have failed to carry this out, knowing she does not have capacity. My daughter is still suffering with her health, now 5 years on because I’ve been accused of FII for years , we have no life, and due to my daughters aggressive seizures, I’ve been physically attacked for 5 years (not her fault) it’s mentally and physically affected both of us with no help in sight! The LA will now just sit around for another 10 months & do nothing so that at 18 years old, adult services will take over. How are these people allowed to get away with what there doing to families.

  2. This is a potentially huge issue, because children with additional needs need their parents to be their advocates and their voice in such situations. And this can be perceived as FII because as parents, we know and understand our children better than anyone else, yet speaking on their behalf could be seen in a negative light when all the vast majority of parents want is the best for their children and wouldn’t dream of fabricating or inducing illness. It’s so sad that these mistakes can be made.

    1. Lack of education and understanding is half the issue.
      Schools, local authorities and even doctors/paediatricians are not up to speed with everything related to children with difficulties.

      1. Vicci Holbrook-Hughes

        While I agree with your point re: understanding etc. I think there is a deeper issue of professional arrogance and labelling culture happening too. I have worked in Nursing, Police, Social Services, and Voluntary Sector and while most people are of course genuine and want to care and there are pocket examples of superb interagency cooperation, there is a big problem with what I call “professionalitis” . This is a belief system of “we not only know best in our profession but we also know more than you in your profession”. This is particularly endemic within Health Services where many of its members cannot grasp that anyone else knows anything. While each profession blames other professions and continues to lack respect for each other by not accepting an ‘equal but different’ model (No, my dear Dr you are not superior to all other professions!) people will fall through the holes in this net of contempt. Further, labelling culture is phenomenally difficult to undo; once a person acquires a label of ‘fabricator’, ‘difficult’, ‘thinks she knows more than we do’, ‘etc. or can be blamed ‘neurotic’, ‘obese’, ‘not trying’ etc. for their situation, there exists a paradox that the more you challenge the label, the deeper it gets embedded.

  3. Sadna Khulpateea

    I am a living example of being failed all round in my quest of support for my daughter, and 5 years of battling a hostile system, has brought me to this point, where could see the story being accepted for FII…
    They learn nothing from previous cases and I wonder what lessons they took from the Oliver McGowan case.
    The Mother, often the expert, criminalised and dehumanised, and so called professionals gets away with murder, literally…

  4. Two examples of personal experience below:
    I was once accused of FII because a consultant refused to believe they could be wrong. Eventually it was proven they were, but I have been accused of seeking a diagnosis because of incompetency in the system. This has meant my daughter suffered delays in treatment and intervention and her speech and development delays are only just being addressed aged 6 despite them presenting from 6-9 months.
    On another occasion I was in hospital with one baby who had had a respiratory arrest at home and was in peri arrest when paramedics arrived (thank goodness I knew CPR) was presenting with signs of struggling with feeding. I asked to go home on NG. I got told ‘your baby is healthy if you demand an NG they’ll end up in foster care’ I was also told reflux was completely normal and I was just anxious.
    The same baby was later shown to have severe silent reflux requiring an NG as bottle feeds put him back into hospital until 6 months old, he needed thickening of his milk, gaviscon, lansoprosole and domperidone as well as amnio acid formula to get even a little bit of a handle on his reflux. That was after oral aversion and 3 months of visits to a&e.
    When reflux was proven a referral to social services was made stating it was unclear why he was on an NG and that I didn’t understand the tube (the aforementioned daughter was on one for a while so that was rubbish). It contained further, easily disproven but fabricated information. Luckily we had dietician, SLT etc on our side.

    These examples show how treatment can be withheld causing detriment to the child when professionals ignore parents.

  5. This has been widespread for sometime. It is not uncommon for one service to raise the possibility to another, then record that discussion as the other professional has the concern. The source of the allegations presented and what can often be found via Subject Access Request rarely tally up.
    Children’s voices are being muted, Parents are being scaremongered into not pushing for proper support. Once an allegation of FII falls flat or has investigation clear parent/carers, I believe a multi-agency meeting must be held with all professionals and parent carers, to confirm where it started, how it escalated, often with no foundation at all, and clarity that the family’s records will receive right to rectification. I have had one client accused and cleared three times this has resulted in her being sacked, in turn losing their home, and the young person over a year later is still struggling to get her medication back on track, as professionals only seem to skim read, and don’t cross reference any information.
    Thank you to all involved in this project 🙏

  6. Every professional who is complicit in these types of accusations should be publicly named, sacked and barred from their profession.

    Families should be compensated for the losses caused by these allegations – enough to cover financial losses and to pay for their choice of independent trauma therapy, separate from the institutions which caused the harm, although money cannot repair all the harm that has been done. It’s not enough to campaign for fabrications of parent/carer harm by professionals to stop. There has to be full accountability for the harm they cause.

  7. After the accusation that i had FII, 2 of my 3 children were subsequently diagnosed with hypermobile Ehlers Danlos syndrome. The Subject Access Request i submitted was ‘fulfilled’ with a return that was so heavily redacted that im still no nearer to understanding.
    We are all deeply affected; i still wake every night, 9 years later, thinking there are police and social workers on the doorstep. Blue lights give me flashbacks. My children, all autistic, are frightened of anyone in the medical or statutory agencies and regard them as dangerous. None of us trust anyone any more and im usually vomiting prior to any appointments. Ive been diagnosed with complex ptsd as have my kids. The process was deeply adversarial – indeed the trainee social worker, who was not adequately supervised, actually effed at me on more than one occasion.
    I trained in nursing. The idea that my eldest could have hEDS came from a chance encounter with a nurse from GOSH.
    The newer guidelines from RCPCH are extremely worrying. They appear to be on the edges of plain discriminatory, yet other research from the Psych field suggests a significant viewpoint that FII doesnt exist.
    I find it disturbing that whilst an allegation process exists, the process for accusations to be properly investigated doesnt appear to be uniform, but far worse – there is no remedy for unfounded allegations to be redressed and the resultant trauma gets ignored.
    The label sticks. A year ago i had stroke-like symptoms. I also had a strong sense of impending doom – id never experienced anything like this myself but had seen it in some of my former patients. It was not treated with any urgency. Months later, an MRI of my head. Months after that, an MRI of my spine.
    Now ive received a letter, almost a year later, from a consultant radiologist who reviewed my spinal scan, stating that my upper spine shows damage to my cervical spine and a CSF space which has been obliterated.
    So i guess i must have been putting on my neurology symptoms then, which are ongoing. It suggests Cervical spondylosis. The GP said all my scans were normal so thank god for the review.

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