Researchers call for “urgent revision” to fabricated or Induced Illness (FII) guidance

Researchers at the University of Leeds have called for “urgent revision” to the Royal College of Paediatrics and Child Health’s fabricated or Induced Illness (FII) guidance, including to address its “failure to recognise the harm to parents and children caused by allegations of FII”.

FII is a term adopted by the Royal College of Paediatrics and Child Health (RCHP) to replace ‘Munchausen syndrome by proxy’.

The research report, published on Tuesday (14 November), considers the prevalence and impact on families in England, Scotland and Wales of being accused of creating or exaggerating their child’s difficulties.

A key finding was that the making of an FII allegation often causes “devastating and life-long trauma” to those accused and to their children.

The report observed that 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.

It was found that disabled parents appear to be four times more likely to be accused of FII than non-disabled parents.

The researchers noted that this suggests a “significant risk of widespread unlawful discrimination against disabled people”.

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.

NHS practitioners were the source of most FII allegations, followed by schools and then local authority children’s services, the report revealed.

The researchers claimed that RCPCH (2021) FII guidance is “likely to give rise to a very high number of ‘false positives’ (people being wrongly accused of FII)”.

The report called for “urgent revision” to the RCPCH guidance including to:

1. address its failure to recognise the harm to parents and children caused by allegations of FII
2. address the danger that its ‘alerting signs’ may have an unlawful discriminatory impact on disabled parents, and
3. acknowledge that its ‘alerting signs’ (of FII) are unsupported by any peer reviewed research.

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 Royal College of Paediatrics and Child Health and the Department for Health and Social Care have been approached for comment.

Lottie Winson