[pessimizer]

> I don't think mimicking someone's Tourette's, which is what these children are doing, makes them mentally unwell.

> It's very possible that they are simply attention-seeking or enjoy the idea of being special.

It depends on what you mean by mentally unwell. If mentally unwell means that they are unhappy, a danger to themselves or others, or having difficulty functioning in the world in an acceptable way - then being attention-seeking to that degree is also clearly being mentally unwell.

If mentally unwell means that there's some physical problem with their brains, then very few people who are mentally well are provably mentally unwell. I would prioritize for help a malingering Tourette's sufferer whose life is falling apart because of that over an "authentic" Tourette's sufferer who has found strategies to cope with the disease in their daily life.

The question shouldn't be to determine if they're really mentally unwell, but to determine whether their illness springs from the same causes that treatments that assume this is a physical problem are effective on, or from different causes (e.g. lack of/need for attention) which might yield to different treatment.