Fabricated or induced illness in children

Fabricated or Induced illness (FII) is a rare form of child abuse. It is recognised by the NHS as happening when a parent or carer exaggerates or deliberately causes symptoms of illness in the child. These behaviours have been given different names (e.g. Munchausen syndrome by proxy).

FII is not a mental-health diagnosis in the adult, but a description of symptoms in a child/children caused by the adult’s behaviour (Royal College of Psychiatrists, March 2020, pg. 7). A recognition of FII is made on paediatric assessment or if the factitious symptom relates to a mental health diagnosis in a child, by CAMHS (Child and Adolescent Mental Health Services).

The Royal College of Paediatrics and Child Health (RCPCH) describe FII as ‘a clinical situation in which a child is, or is very likely to be, harmed due to parent(s) behaviour and action, carried out in order to convince doctors that the child’s state of physical and/or mental health and neurodevelopment is impaired (or more impaired than it is)’ (RCPH, 2021, p.11).

While parents may not intend to deceive doctors, it may be harmful as a child could have unnecessary treatment or tests, may be convinced that they are ill, or their education may be disrupted.

Concerns are likely to be raised, when there is a discrepancy between the findings of a medical professional and the signs and symptoms reported by a parent. A paediatrician should be involved, and they will refer any suspected case of FII to social services so that protective measures can be taken to safeguard the child.

This can lead into local authority care proceedings or the Public Law Outline pre proceedings process, if there is perceived to be a risk of significant harm to a child.

There are increasing numbers of cases in which a parent(s) of a neurodivergent child or a child with a multisystemic condition are accused of FII. This can often be down to a lack of knowledge about the condition and/or the child presenting differently to his/her parent than to his/her school.

The expert solicitors at Miles & Partners are experienced in all aspects of the law regarding children, and we can support parents and carers who are suspected of fabricating or inducing illness in a child. We have a wealth of experience in FII cases and have achieved positive outcomes for a number of parents accused of FII.

Who we can help

We support parents, grandparents, other relatives, and carers when there are suspicions of Fabricated or Inducted Illness.

We also act separately for children who are old enough and have sufficient understanding to instruct a solicitor themselves. Generally, this applies to teenagers only, but sometimes children as young as 10 can be found to be of sufficient understanding.

How we can help

We can represent you in care proceedings and help you obtain evidence to challenge any allegation of FII. This may include the obtaining of expert reports from specialists with expertise in child health

Similarly, if social services have not yet issued proceedings, we can advise you in the early stages of an allegation being made, on how to avoid the matter progressing to court. We can contact the local authority on your behalf with any evidence to challenge the allegation of FII and ensure the local authority are conducting its child protection procedures in accordance with relevant statutory and non-statutory guidance.

Funding for legal advice or representation

Legal Aid funding is available for parents and others with parental responsibility for the child if their local authority is accusing you of fabricating or inducing illness in a child and has commenced care proceedings. This type of legal aid is non means tested so any carer with parental responsibility will be entitled to free representation.

If the matter has not yet progressed to court, you may be eligible for Legal Help. We can assess your eligibility for legal aid when you first make contact with the firm.