the majority are fake. regarding the tv mediums, while i do believe some are real, i doubt everything presented for the show is. if there is that many spiritual events surrounding one person to fill a season or more, then i would like to believe scientist would like to study these events to prove/disprove the afterlife. at the end of the day, people are fascinated with spirits, and if a show about someone speaking to your departed loved ones means ratings and money, of course they will make a show about it.
last year they were talking about making a show about practising pagans, they wanted to shoot a type of docu-drama. if such a show was to make it off the ground, it would be like these shows, every episode three spiritual encounters and shocking reactions. the cast might all be pagans who know what they're doing but whatever makes money is what will be shown. mediums are the same. they might live normal lives, but they speak to spirits for a living. will the cameras focus on them getting the kids ready for school, cooking, cleaning, and grocery shopping? or will they happen to keep bumping into people with tragic stories of loved ones who have died and the spirit found the medium.