Inter-agency practice in suspected cases of Munchausen Syndrome by Proxy (Fictitious Illness by Proxy): dilemmas for professionals

Munchausen Syndrome by Proxy (MSBP) or Fictitious Illness by Proxy, the fabrication or induction of illness in a child, is a recognized form of child abuse in many countries. As such it is subject to inquiry under child protection legislation. Child protection legislation and practice guidance in Australia, the USA and most European countries requires professionals from a variety of disciplines to work together regarding the recognition, investigation and short and long-term assessment of the case. However, practitioners and managers find cases of MSBP difficult to manage at personal, professional and organizational levels. This paper identifies some of the tensions and dilemmas encountered by professionals when working with suspected cases of MSBP. Consideration is given to the impact that this has on multi-disciplinary practice in terms of working in partnership with other professionals and the family. The paper includes suggestions for promoting effective inter-agency practice to protect children who are the victims of this form of abuse.