Is "Malingering" a Pelagian concept?

As a psychiatrist at a university-affiliated teaching hospital, I spend part of my week in my hospital’s emergency department supervising psychiatry residents and evaluating patients who present in psychiatric crisis.  It is unpredictable and sometimes difficult work:  patients who present to a psychiatric emergency service are representative neither of the general population nor of those who seek outpatient mental health treatment.  We see people who are not doing well:  many are intoxicated with and/or withdrawing from alcohol and other drugs; many have no relationship either with a mental health clinician or with any other significant community of support; many are off any prescribed medications; some are agitated, belligerent, and even assaultive.  I try, though not always with success, to keep my trainees from becoming bitter and cynical about “frequent flyers” who present repeatedly in crisis.