FII is rare, but accusations are not. The BASW guide shows how weak indicators can harm families — and why social workers must balance safeguarding with fairness, validity and ethics.
This is a summary of the report Fabricated or Induced Illness (FII) and Perplexing Presentations: A Practice Guide for Social Work Practitioners (Long, Eaton, Russell, Gullon-Scott & Bilson, 2022), published by the British Association of Social Workers (BASW). BASW is the UK’s professional body for social work, promoting high standards of practice and ethics.
Risks and Family Impact:
The guide warns that when concerns about Fabricated or Induced Illness (FII) or Perplexing Presentations (PP) lack a sound evidence base, families can face serious consequences. FII is not a medical diagnosis but a safeguarding label, and confirmed cases are described as “extremely rare” (para 1.4). Yet weak or untested indicators may wrongly implicate parents, particularly those who are disabled, neurodivergent, or advocating for children with complex needs.
Concerns sometimes arise after parents make complaints or request EHCPs (para 5.3). Mothers are disproportionately targeted: “It is usually mothers who are accused of FII, often in the context of disputes with professionals” (para 5.6). Such assumptions can have devastating effects.
The guide includes testimonies that bring these risks into sharp focus. One parent recalled: “I was accused of fabricating my daughter’s difficulties because she appeared fine at school, but at home she was overwhelmed and masking” (para 6.2). Another described how suspicion arose only after he sought help following his wife’s death, when his son later needed emergency surgery for a twisted bowel (para 6.4). These families report feeling traumatised, disempowered, and alienated from services, with genuine support needs overlooked.
The lesson is clear: premature judgments based on unreliable indicators do not strengthen safeguarding — they undermine it. Wrongful accusations erode trust, delay appropriate help, and place families under unnecessary strain.
Conclusion:
The report calls on social workers to use professional curiosity, reflective supervision, and an ethical, strengths-based approach. It also recognises that they do valuable and often challenging work in highly complex circumstances (para 7.1). Done well, this balance protects children while also respecting and supporting families.
The report can be found here: https://new.basw.co.uk/sites/
Disclaimer: This is a summary of the report and not legal or professional advice.
Sean Kennedy
