Why scammers fake illness for cash, according to a psychologist

Queensland woman Amanda Maree Power has recently been jailed after faking cancer and fraudulently raising about A$24,000 from friends, family and strangers over several years – including to pay for holidays and fake medical bills.

Among Power’s victims were those diagnosed with cancer and her former employer, Cancer Council Queensland.

Power is the latest person found to have faked an illness and to have benefited financially, and in other ways.

Perhaps the most notorious, Australian Belle Gibson, was not criminally charged. She was however found liable in 2017 for breaching various consumer laws and fined $410,000. She had built a wellness empire based on a lie – that nutrition and a healthy lifestyle had cured cancer she didn’t have.

Canada’s Ashley Kirilow and Maddison Russo from the United States have also been convicted of fraud for faking cancer.

But why would someone do this? We don’t know the full details of Power’s motivations. But generally speaking, there are a few reasons why people fake illness.

Is it a mental health condition?

Only the individual truly understands why they’re faking an illness. But there are some underlying explanations.

Let’s start with malingering, which is a behaviour, not a diagnosis. This is deliberate and specific lying about having an illness to obtain an external goal, such as getting money or avoiding responsibilities (such as working).

There are three main types:

• faking an illness you don’t have

• claiming you still have the illness when you have recovered

• exaggerating the extent of the symptoms of an illness you do have.

But in rare cases, some people who fake their illness aren’t doing it for money or to avoid an obligation. They do so to meet an internal psychological need, such as the need for care and attention from others, to reassure their self worth, or for acceptance and belonging. An additional consequence can be financial gain but that is not their goal.

These are the hallmarks of someone with factitious disorder, which used to be called Munchausen syndrome. When someone fakes someone else’s illness, usually a child’s, this is called Munchausen by proxy.

How common is this?

We don’t know exactly how common malingering and factitious disorder are because both are hard to detect. But we think both are rare. To confirm either requires clear evidence or a confession, and both are rarely available.

Mislabelling can lead to inappropriate treatment or consequences. For example, we don’t want to mistake factitious disorder for malingering and vice versa.

People with factitious disorder need treatment. Most would say people who malinger need to be held accountable.

Treating someone diagnosed with factitious disorder usually involves targeting the person’s unmet psychological needs and other factors, using structured psychotherapy and psychotropic medicine (ones that affect the mind, emotions and behaviour). But because it is so difficult to detect, there hasn’t been a significant increase in research on this in recent years.

Malingering and factitious disorder can also occur together, making the situation even more complicated to differentiate, diagnose and address.

In the criminal system, differentiation between the two is less relevant. Here, the fraud itself is the focus.

Why are scammers hard to spot?

We aren’t as good as we think at detecting when others are deceiving us.

There are nearly always inconsistencies in how a faker presents. However, mostly these aren’t enough to identify faking, and most people will dismiss small things that don’t add up.

This is because we tend to interpret and recall information in a way that confirms our existing beliefs – known as confirmation bias.

Most people want to believe their loved one. They believe in helping others. They don’t want to be the person to accuse someone of faking.

Does social media make it easier to fake?

In short, yes. To successfully fake an illness you need detailed knowledge of symptoms, rather than relying on oversimplified stereotypes. Successful faking also involves convincing acting, maintaining consistency in how you present, and then remembering and managing previous lies to weave a convincing narrative.

Announcing a serious illness such as cancer on social media usually results in immediate offers of sympathy, support and attention. Access to support groups, charities and associations inevitably provides more exposure to people with the genuine condition, assisting the person who is faking to better mimic the illness.

Crowdfunding platforms such as GoFundMe allow people to quickly and simply set up donation campaigns without requiring medical verification.

Social media also allows claims of illness, and news of fundraising, to spread far wider and faster than it would in real life.

The ripple effects of faking

The impact of someone faking an illness can be far reaching and devastating. People close to the person faking often feel shocked, betrayed and angry. Many will have provided financial, emotional and practical support, often sacrificing their own needs to help. They may not be so easily able to trust other people again.

People who actually have cancer or the illness the person is faking are also deeply affected. Being seriously unwell creates a unique combination of fear and vulnerability. Learning someone is an imposter after thinking they were your ally in the battle against the same illness you have can cause significant psychological harm.

The lost of trust means there’s also the risk it can impact future support and donations to those with genuine need, including to charities.

While it may be little consolation to those affected, it’s important to remember such cases are rare. Most people requesting support during serious illness are sincere.