It was three years before Kelly Boone saw her daughter’s face free from a thick layer of make-up.
Avella was 11 years old when she first began exhibiting symptoms of severe body dysmorphic disorder (BDD) – even going as far as to consult a cosmetic surgeon and begging for rhinoplasty.
At the most severe, it left her housebound and she would cover her head with a towel just to go to the toilet, refusing to let her family see her without the thick layers of foundation.
On one “devastating” occasion, her father Patrick opened a package that had arrived for Avella – it contained injections and filler bought off a dodgy website.
It was not the first time Avella had tried “self-surgery”.
“She didn’t actually use any of the things she bought – by luck,” Kelly, from south Devon, said.
“It was crippling. She was a recluse, just living in her room.
“I was sliding trays of food across her bedroom floor with her in a darkened room at one point.”
As Avella, now 17, makes steps towards recovery, Kelly fears the cost of living crisis will make things harder.
Two showers a day
Although Avella no longer wears layers of make-up she has a strict hygiene routine – including two showers a day – to help her cope with her body dysmorphia.
Amid the soaring cost of energy, bills and inflation, there are concerns it could become harder for the family.
The family’s monthly gas bill has risen from £400 to more than £500. But for Kelly, the price is non-negotiable.
“She’s starting to recover and the gains we’ve made, we can’t negotiate on that,” Kelly told Sky News.
“It’s quite ritualistic and quite necessary to her, and we can’t make any concessions on those, whilst they might be a luxury to some people.
“So we cannot cut down our water bill, the cost of gas – these things are non-negotiable, so our bills are extortionate.”
Avella also cannot get public transport. “She cannot sit face to face with someone,” her mother said – so instead they have to drive her to therapy appointments, and previously to college.
“I can’t believe how quickly my tank gets down to zero,” said Kelly. “It’s very expensive.”
Image: Avella, aged 11, before she began showing symptoms of body dysmorphia
‘Her recovery has to be at her pace – not at my energy bill convenience’
Kelly said seeing Avella suffer is “excruciating”.
“I would do anything to swap places with her,” she said.
“It’s been really difficult and gut-wrenching, but we’ve also had some really high moments.
“Like the day she decided to wipe her make-up off and come down and show us.
“It was the first time in three years we had seen her without any make-up on.”
As the family takes each day “hour by hour”, none of them want to see Avella slide back to where she was before.
The mother of three said: “Any requested change to her routine, other than what she does for herself of her own choosing would cause immediate anxiety and distress.
“This can snowball to affect other aspects of how she perceives herself. Her recovery has to be at her own pace not at my convenience due to rising energy bill concerns.”
One in three fear for their children
Kelly is not alone, as new research shows a third of parents think the cost of living crisis will significantly affect their children’s mental health.
These children, who have spent their formative teenage years living through the COVID pandemic, face coming of age in a cost of living crisis.
A poll of 2,150 UK parents – by Savanta ComRes and commissioned by the King’s Maudsley Partnership – found a third of parents (33%) feel their child is currently experiencing mental health difficulties.
This rises to 43% of parents with children ages between 16 and 17.
The most common symptom, or behaviour, noticed by parents is anxiety (68%), which is cited by nearly twice as many parents as the next most common response – which is depression or low mood episodes in their children (37%).
Kelly, like many parents, experienced delay after delay in getting treatment for Avella.
Bruce Clark, a consultant child and adolescent psychiatrist and specialist in OCD, BDD and related disorders, said he had seen a “huge rise in mental health presentations to services, both in referrals to generic services” as well as emergency crisis referrals since the pandemic.
The clinical director of Child and Adolescent Mental Health Service, who works at the South London and Maudsley Mental Health Trust said while there are charities that help fill some of the gaps, the sector – particularly around research – is “grossly underfunded”.
The London trust is on the brink of opening a new pioneering mental health centre for children and young people, the Pears Maudsley Centre. Part of the new centre will involve a clinical hub, with research vital to improving support for young people.
“There was always an aspiration to deliver for 35% of the mental health needs in the community,” Dr Clark said.
“Well, we want to do more than 35%. I’d like to find ourselves in a situation with the right clinical research background to deliver as close to 100%.
“You’d never find that acceptable to say we’ll treat 35% of the cancer morbidity in our society, so it would be brilliant if we could not have that limited aspiration for children’s mental health.”
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Safeguarding minister Jess Phillips has told Sky News that councils that believe they don’t have a problem with grooming gangs are “idiots” – as she denied Elon Musk influenced the decision to have a national inquiry on the subject.
The minister said: “I don’t follow Elon Musk’s advice on anything although maybe I too would like to go to Mars.
“Before anyone even knew Elon Musk’s name, I was working with the victims of these crimes.”
Mr Musk, then a close aide of US President Donald Trump, sparked a significant political row with his comments – with the Conservative Party and Reform UK calling for a new public inquiry into grooming gangs.
At the time, Ms Phillips denied a request for a public inquiry into child sexual exploitation in Oldham on the basis that it should be done at a local level.
But the government announced a national inquiry after Baroness Casey’s rapid audit on grooming gangs, which was published in June.
Asked if she thought there was, in the words of Baroness Casey, “over representation” among suspects of Asian and Pakistani men, Ms Phillips replied: “My own experience of working with many young girls in my area – yes there is a problem. There are different parts of the country where the problem will look different, organised crime has different flavours across the board.
“But I have to look at the evidence… and the government reacts to the evidence.”
Ms Phillips also said the home secretary has written to all police chiefs telling them that data collection on ethnicity “has to change”, to ensure that it is always recorded, promising “we will legislate to change the way this [collection] is done if necessary”.
Operation Beaconport has since been established, led by the National Crime Agency (NCA), and will be reviewing more than 1,200 closed cases of child sexual exploitation.
Ms Phillips revealed that at least “five, six” councils have asked to be a part of the national review – and denounced councils that believed they don’t have a problem with grooming gangs as “idiots”.
“I don’t want [the inquiry] just to go over places that have already had inquiries and find things the Casey had already identified,” she said.
She confirmed that a shortlist for a chair has been drawn up, and she expects the inquiry to be finished within three years.
Ms Phillips’s comments come after she announced £426,000 of funding to roll out artificial intelligence tools across all 43 police forces in England and Wales to speed up investigations into modern slavery, child sex abuse and county lines gangs.
Some 13 forces have access to the AI apps, which the Home Office says have saved more than £20m and 16,000 hours for investigators.
The apps can translate large amounts of text in foreign languages and analyse data to find relationships between suspects.
Her comments followed the departure of the prince and several others from the organisation in March.
They had asked her to step down, alleging it was in the “best interest of the charity”.
Dr Chandauka told Sky News that Harry had “authorised the release of a damaging piece of news to the outside world” without informing her or Sentebale directors.
The Duke and Duchess of Sussex declined to offer any formal response.
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4:43
Why was Prince Harry accused of ‘bullying’?
‘Strong perception of ill-treatment’
The Charity Commission said it was reporting after a “damaging internal dispute emerged” and has “criticised all parties to the dispute for allowing it to play out publicly”.
That “severely impacted the charity’s reputation and risked undermining public trust in charities more generally”, it said.
But it found no evidence of “widespread or systemic bullying or harassment, including misogyny or misogynoir at the charity”.
Nevertheless, it did acknowledge the “strong perception of ill-treatment felt by a number of parties to the dispute and the impact this may have had on them personally”.
It also found no evidence of “‘over-reach’ by either the chair or the Duke of Sussex as patron”.
‘Confusion exacerbated tensions’
But it was critical of the charity’s “lack of clarity in delegations to the chair which allowed for misunderstandings to occur”.
And it has “identified a lack of clarity around role descriptions and internal policies as the primary cause for weaknesses in the charity’s management”.
That “confusion exacerbated tensions, which culminated in a dispute and multiple resignations of trustees and both founding patrons”.
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4:43
Why was Prince Harry accused of ‘bullying’?
Harry: Report falls troublingly short
A spokesperson for Prince Harry said it was “unsurprising” that the commission had announced “no findings of wrongdoing in relation to Sentebale’s co-founder and former patron, Prince Harry, Duke of Sussex”.
They added: “Despite all that, their report falls troublingly short in many regards, primarily the fact that the consequences of the current chair’s actions will not be borne by her, but by the children who rely on Sentebale’s support.”
They said the prince will “now focus on finding new ways to continue supporting the children of Lesotho and Botswana”.
Dr Chandauka said: “I appreciate the Charity Commission for its conclusions which confirm the governance concerns I raised privately in February 2025.”
But she added: “The unexpected adverse media campaign that was launched by those who resigned on 24 March 2025 has caused incalculable damage and offers a glimpse of the unacceptable behaviours displayed in private.”
All police forces investigating grooming gangs in England and Wales will be given access to new AI tools to help speed up their investigations.
The artificial intelligence tools are already thought to have saved officers in 13 forces more than £20m and 16,000 hours of investigation time.
The apps can translate large amounts of text in foreign languages from mobile phones seized by police, and analyse a mass of digital data to find patterns and relationships between suspects.
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2:00
Grooming gang inquiry: ‘Our chance for justice’
‘We must punish perpetrators’
The rollout is part of a £426,000 boost for the Tackling Organised Exploitation (TOEX) programme, which supports officers to investigate complex cases involving modern slavery, county lines and child sex abuse.
“The sexual exploitation of children by grooming gangs is one of the most horrific crimes, and we must punish perpetrators, provide justice for victims and survivors, and protect today’s children from harm,” said safeguarding minister Jess Phillips.
“Baroness Casey flagged the need to upgrade police information systems to improve investigations and safeguard children at risk. Today we are investing in these critical tools.”
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1:36
Key takeaways from the Casey review
Lack of ethnicity data ‘a major failing’
Police forces have also been instructed by the home secretary to collect ethnicity data, as recommended by Baroness Casey.
Her June report found the lack of data showing sex offenders’ ethnicity and nationality in grooming gangs was “a major failing over the last decade or more”.
She found that officials avoided the issue of ethnicity for fear of being called racist, but there were enough convictions of Asian men “to have warranted closer examination”.
The government has launched a national inquiry into the abuse and further details are expected to be announced in the coming weeks.