03/01/2025
This afternoon, as I sat reflecting on a card sent to me, I found myself unable to smile. Instead, I felt a deep sense of unease. The gratitude expressed in the card, while heartfelt, stirred something unsettling within me. I shouldn't need to be thanked for addressing something that should not be happening within our systems—whether in health, education, or social care.(Or any other area).
The past year has been another challenging one, filled with difficult cases and conversations surrounding Fabricated or Induced Illness (FII). Too often, my role has been to clarify what FII is not, both directly with families and indirectly, behind the scenes. While I am always willing to share research, facts, and insights on this complex topic, I find myself urging professionals across all sectors to reflect on their own understanding, their practices, and their responsibilities.
Let’s try another way this year. Regardless of who you work for, remember this: you are registered to a professional body, aside of your employer. Your role, above all else, is to protect others. If you don’t understand something, don’t carry on regardless. Educate yourself, seek out someone who does understand, and challenge yourself to grow. Remember the weight of your registration and the responsibility it entails. More importantly, remember the well-being of the public, the very reason for our work across all sectors.
Question yourself and your practice. Are you truly informed and equipped to make the decisions you’re making? Are you adhering to evidence-based approaches, or are you relying on assumptions? Are you challenging poor practice, and are you prepared to confront cultures that perpetuate matters with little or no evidence? If not, why not? These are the questions we must ask ourselves every day.
We must recognise that inadequate knowledge in areas like FII is dangerous—not only for the individuals involved but for the integrity of our professions. Evidence-based practice, defensible decision-making, and a thorough understanding of patterns and narratives are essential. We must challenge poor practice when we see it and confront cultures that rely on matters supported by little to no evidence. This is not only our duty but our fundamental purpose as professionals.
The pressures we face within the system—whether due to resource constraints, organisational expectations, or systemic inefficiencies—cannot become excuses for poor decisions. Bad practice, regardless of the reason, has consequences. When things go wrong, the system may not stand by us as individuals. It is vital to remember why we entered our professions in the first place: to serve with compassion, dignity, and respect.
As we step into the year ahead, let us reflect on our core values, the codes of practice we uphold, and the ethical boundaries we are committed to maintaining. The pressures will not disappear, but our commitment to serving the public well must remain steadfast. The memories of our actions—good or bad—will stay with us long after the immediate challenges have passed.
Let us carry these reflections forward, remembering the weight of our responsibilities and the power of our choices. In every decision, let us honour the trust placed in us by those we serve, and let us never lose sight of the humanity that underpins all we do.
Independent Social Work support.
