Perplexing Presentations (PP) and Fabricated or Induced Illness (FII) are safeguarding concerns in which a child’s reported symptoms, clinical presentation, or parental accounts show significant discrepancies. PP describes situations where the child’s true health status is unclear but without immediate serious risk. FII is classified as a mental health disorder and includes fabrication, exaggeration, or induction of illness that can lead to physical and emotional harm through unnecessary medical interventions.
Health visitors play a key role through regular contact with families, observing parent–child interactions, identifying discrepancies between reported symptoms and observed behaviour, maintaining accurate records, contributing to multi-agency discussions, and escalating concerns through their locally agreed pathways for safeguarding, child health and adult mental health services when PP or FII is suspected.
The Good Practice Points below were developed to enhance health visitors’ (HVs) understanding of Fabricated or Induced Illness (FII) and its impacts on their role and practice.
iHV Resources
📃 Good Practice Points and Parent Tips
Developed in collaboration with topic experts, health visitors, and other professionals, our resources draw on the latest available evidence at the time of publication. Each resource is produced through a robust quality assurance process and peer reviewed to ensure accuracy, relevance, and strong alignment with health visiting practice.
FII 1 - Recognising fabricated or induced illness in health visiting practice
Good Practice Point
FII 3 - Impact of FII cases on professionals: Addressing potential dilemmas in health visiting practice
Good Practice Point
