By Ashanea Parker
Aaron Holland estimates he played sick once a week during his freshman and sophomore years. As a senior at Richard Wright Charter School in Washingn D.C., he no longer takes time off under false pretenses but he knows a dozen people who do.
“Just off the top of my head I know 13 or so people who do what I did,” Holland, 17, said.
According to ieTherapy.com, malingering is a fabricated mental illness. “It is the the deliberate intention of an individual to exaggerate their mental or physical symptoms due to a variety of motives.”
The website estimates more than percent of chronic pain patients are malingering and 33 percent of disability claims are the result of malingering.
Although it has not advanced to the point of being diagnosible a rising number of nurses, doctors, social workers, teachers and parents are dealing with the problem.
Melissa Sporn, a McLean, Va. child psychologist told Urban Health Media Project that in her current practice she sees patients who malinger because they are seeking accommodations for college entrance exams like the SATs.
In her previous work with the juvenile court system in Fairfax County, it was malingering to get leniency from the court.
“Maybe one in 10 patients I saw would” fake it, she said. “Sometimes it was just a subtle exaggeration and they learn that if I’m more symptomatic the courts will go light.”
Dr. Sporn said the court uses tests to identify when someone is malingering by identifying the exaggerated symptoms. One such test literally deals with how a patient responds to pleasant and unpleasant smells. People who are faking it will usually respond in the opposite way, the doctor said.
Dr. Sporn said another measure is simply looking at the circumstances. She said one of her patients is an adolescent prone to panic attacks.
“Interestingly enough her panic attacks occur when she has something due or when she’s been caught doing something wrong,” Dr. Sporn said. “It diffuses her parents punishing her, her having consequences at school. It feels too contrived and perfectly timed.”
The attacks never occur during pleasant moments or events. People who have panic attacks don’t want to have them and they occur randomly.
The important issue in malingering is it can take therapy time from patients who need treatment. According to the Kaiser Family Foundation, mental health treatment shortages are pervasive. Fewer than half the people nationally who need care (44 percent), have it. Some states, like Delaware have treatment available for fewer than 10% of the population that need it.
In Washington, D.C., there are enough mental health care treatment professionals for 49% of the population.
For Holland, he never thought about whether he was keeping someone else from getting help. He rarely saw the school nurse present to talk to her.
His primary consequence was avoiding class and often assignments that were due which he had not completed.
“My life was very stressful to me. At times I would say I need a break. I was depressed or anxious so I would tell my parents I was sick,” he said. ” I would say to myself I had a whole project due and I didn’t do it. If I can stay home I will do it.”
His parents didn’t always buy it. Today he is too busy to malinger as he tries to do college applications and other activities: “I toned it down.”