Fabricated or induced illness ( formerly Munchausens By Proxy) is a rare form if child abuse. NHS choices website reckons that the incident of FII is 89 cases in every 100,000, however it does not quite its source. The government document "Safeguarding children in whom illness is fabricated or induced" (2008) put the figure at 0.5 out if every 100,000 over 5 and 2.8 in every 100,000 preschoolers, or 1 child in a million per year.
FII takes many forms but usually includes;
- poisoning yo induce symptoms
- physically inducing symptoms
-over or under medicating
- claiming false symptoms that are not easily verified
- exaggerating symptoms
- obtaining specialist treatment when not needed
- falsely alleging psychological illness in a child
However, despite the extreme and very rare nature of FII, accusations of FII are very commonplace. There is a worrying trend of using FII accusations routinely in child protection against any family that complains about services, is seen as "difficult", does not comply blindly or in any other way annoys professionals involved.
Current training for HCPs on FII gives a list if symptoms which is very worrying. These include, use of complaints procedures, seeking out advocates and support, advocating on behalf of the child and seeking multiple diagnosis. These behaviours are blatantly the normal behaviours of parents fighting for a seriously ill child or a child with additional needs who is being let down by the system.
What we end up with is a system that attacks families that are trying to care for children with rare, complex, invisible, or multiple illnesses, conditions and needs.
I compiled a survey to look at the extent of this problem as I am personally aware of a number of families who have been bullied in this way. What I found did not shock me, but I hope it can highlight this very real problem in our society.
I received 100 responses to my survey, of those 74% had been accused of FII. This worrying trend if FII is very ableist, targeting those families who have multiple members with extra needs, illness, or disability. 56% of parents accused if FII had an an additional need, chronic illness or disability themselves.
One surprise was that the accusations of FII seemed to be thrown at parents from a variety of socioeconomic backgrounds:
35 % were single parents in benefits
13% were a couple on benefits
47% were a couple with one or more person working
10% were single working parents
So it would seem that these accusations are not targeted at one class alone, however, families whose children have additional needs, chronic illness or disability are more likely to experience poverty (Kuper et Al 2012). Poverty of course, not being measured by whether or not your parents work.
Bullying by social services is if course, not limited to FII accusations. There does seem to be many similar trends through other malicious practice.
Of those surveyed who had experienced child protection proceedings, 60% had found themselves facing child protection proceedings following a complaint they had made. Worryingly, 14.5% faced child protection procedures after complaining about a professional abusing their child. If complaints of abuse by professionals like social workers and health care professionals are silenced with malicious proceedings, how can we trust those professionals with our children?
Within those parents who had experienced child protection proceedings, 59% have an extra need, chronic illness or disability themselves. Although it may be argued that parents with SEND or chronic illness may need additional support, this is not what is happening here. This is a high incident of these parents facing accusations of child abuse or neglect. A massive over representation of those with additional needs, illness or disability and shows the blatant ableist within health and social care.
This is reflected within the children of the families experiencing child protection proceedings, 91% of the families who faced child protection proceedings had a child with additional needs, illness or disability.
Remember again, that this isn't families being supported by social service, but those accused of abuse and neglect.
"Invisible" Illness and disabilities seem to be a particular target for these proceedings, namely;
- Autistic Spectrum Disorder
- Ehlers Danlos Syndrome
- Myalgic Encephalomyelitis
- Attention Deficit Hyperactivity Disorder
- Mental health difficulties
The ableist nature of society against those with Invisible illness and disability is well documented and there are current campaigns seeking to highlight Invisable illness and disability.
However this does not seem to have penetrated the health and social care community. Instead if offering support and understanding to those with these conditions, there seems to be a culture of disbelief.
This leads to mistrust and therefore a reduced likelihood of compliance and engagement with health and social care, which only increases their disbelief and suspicion.
One major point I feel need to be made is that while there are major cuts to health and social care, combined with higher rates of referral to social services, means resources are overstretched. Focusing resources on bullying these innocent families leaves victims of actual abuse vulnerable and perpetrators free to abuse these children without consequence. The results are far reaching for all of society and require a response from the government to tackle this problem and provide all families with the support they require.