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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A care worker who reported the alleged abuse of an elderly care home resident, which triggered a criminal investigation, is facing destitution and potential removal from Britain after speaking up.
“Meera”, whose name we have changed to protect her identity, said she witnessed an elderly male resident being punched several times in the back by a carer at the home where she worked.
Sky News is unable to name the care home for legal reasons because of the ongoing police investigation.
“I was [a] whistleblower there,” said Meera, who came to the UK from India last year to work at the home.
“Instead of addressing things, they fired me… I told them everything and they made me feel like I am criminal. I am not criminal, I am saving lives,” she added.
Image: ‘Meera’ spoke up about abuse she said she witnessed in the care home where she worked
Like thousands of foreign care workers, Meera’s employer sponsored her visa. Unless she can find another sponsor, she now faces the prospect of removal from the country.
“I am in trouble right now and no one is trying to help me,” she said.
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Meera said she reported the alleged abuse to her bosses, but was called to a meeting with a manager and told to “change your statement, otherwise we will dismiss you”.
She refused. The following month, she was sacked.
The care home claimed she failed to perform to the required standard in the job.
She went to the police to report the alleged abuse and since then, a number of people from the care home have been arrested. They remain under investigation.
‘Migrants recruited because many are too afraid to speak out’
The home has capacity for over 60 residents. It is unclear if the care home residents or their relatives know about the police investigation or claim of physical abuse.
Since the arrests, the regulator, the Care Quality Commission (CQC), carried out an investigation at the home triggered by the concerns – but the home retained its ‘good’ rating.
Meera has had no reassurance from the authorities that she will be allowed to remain in Britain.
In order to stay, she’ll need to find another care home to sponsor her which she believes will be impossible without references from her previous employer.
She warned families: “I just want to know people in care homes like these… your person, your father, your parents, is not safe.”
She claimed some care homes have preferred to recruit migrants because many are too afraid to speak out.
“You hire local staff, they know the legal rights,” she said. “They can complain, they can work anywhere… they can raise [their] voice,” she said.
Image: Sky’s Becky Johnson spoke to ‘Meera’
Sky News has reported widespread exploitation of care visas and migrant care workers.
Currently migrants make up around a third of the adult social care workforce, with the majority here on visas that are sponsored by their employers.
As part of measures announced in April in the government’s immigration white paper, the care visa route will be closed, meaning care homes will no longer be able to recruit abroad.
‘Whole system is based on power imbalance’
But the chief executive of the Work Rights Centre, a charity that helps migrants with employment issues, is warning that little will change for the tens of thousands of foreign care workers already here.
“The whole system is based on power imbalance and the government announcement doesn’t change that,” Dr Dora-Olivia Vicol told Sky News.
She linked the conditions for workers to poor care for residents.
Image: Work Rights Centre CEO Dr Dora-Olivia Vicol
“I think the power that employers have over migrant workers’ visas really makes a terrible contribution to the quality of care,” she said.
Imran agrees. He came to the UK from Bangladesh, sponsored by a care company unrelated to the one Meera worked for. He says he frequently had to work 14-hour shifts with no break because there weren’t enough staff. He too believes vulnerable people are being put at risk by the working conditions of their carers.
Migrant workers ‘threatened’ over visas
“For four clients, there is [a] minimum requirement for two or three staff. I was doing [it] alone,” he said, in broken English.
“When I try to speak, they just directly threaten me about my visa,” he said.
“I knew two or three of my colleagues, they are facing the same issue like me. But they’re still afraid to speak up because of the visa.”
A government spokesperson called what happened to Imran and Meera “shocking”.
“No one should go to work in fear of their employer, and all employees have a right to speak up if they witness poor practice and care.”
James Bullion, from the CQC, told Sky News it acts on intelligence passed to it to ensure people stay safe in care settings.
Donald Trump may be denied the honour of addressing parliament on his state visit to the UK later this year, with no formal request yet submitted for him to be given that privilege.
Sky News has been told the Speaker of the House of Commons, Sir Lindsay Hoyle, hasn’t so far received a request to invite the US president to speak in parliament when he is expected to visit in September.
It was confirmed to MPs who have raised concerns about the US president being allowed to address both houses.
Kate Osborne, Labour MP for Jarrow and Gateshead East, wrote to the speaker in April asking him to stop Mr Trump from addressing parliament, and tabled an early-day motion outlining her concerns.
“I was happy to see Macron here but feel very differently about Trump,” she said.
“Trump has made some very uncomfortable and worrying comments around the UK government, democracy, the Middle East, particularly around equalities and, of course, Ukraine.
“So, I think there are many reasons why, when we’re looking at a state visit, we should be looking at why they’re being afforded that privilege. Because, of course, it is a privilege for somebody to come and address both of the houses.”
But the timing of the visit may mean that any diplomatic sensitivities, or perceptions of a snub, could be avoided.
Image: France’s President Emmanuel Macron addressed parliament during his state visit this month
Lord Ricketts, a former UK ambassador to France, pointed out that parliament isn’t sitting for much of September, and that could help resolve the issue.
In 2017, he wrote a public letter questioning the decision to give Donald Trump his first state visit, saying it put Queen Elizabeth II in a “very difficult position”.
Parliament rises from 16 September until 13 October due to party conferences.
The dates for the state visit haven’t yet been confirmed by Buckingham Palace or the government.
However, they have not denied that it will take place in September, after Mr Trump appeared to confirm they were planning to hold the state visit that month. The palace confirmed this week that the formal planning for his arrival had begun.
With the King likely to still be in Scotland in early September for events such as the Braemar Gathering, and the anniversary of his accession and the death of Queen Elizabeth on the 8th September, it may be expected that the visit would take place sometime from mid to the end of September, also taking into consideration the dates of the Labour Party conference starting on the 28th September and possibly the Lib Dem’s conference from the 20th-23rd.
Image: Mr Trump has said he believes the trip to the UK will take place in September. Pic: Reuters
When asked about parliamentary recess potentially solving the issue, Ms Osborne said: “It may be a way of dealing with it in a very diplomatic way… I don’t know how much control we have over Trump’s diary.
“But if we can manoeuvre it in a way that means that the House isn’t sitting, then that seems like a good solution, maybe not perfect, because I’d actually like him to know that he’s not welcome.”
A message from the speaker’s office, seen by Sky News, says: “Formal addresses to both Houses of Parliament are not automatically included in the itinerary of such a state visit.
“Whether a foreign head of state addresses parliament, during a state visit or otherwise, is part of the planning decisions.”
Image: Mr Trump made his first state visit to the UK in June 2019 during his first presidency. File pic: Reuters
It’s understood that if the government agrees to a joint address to parliament, the Lord Chamberlain’s office writes to the two speakers, on behalf of the King, to ask them to host this.
It will be Mr Trump’s second state visit.
During his first, in 2019, he didn’t address parliament, despite the fact that his predecessor, Barack Obama, was asked to do so.
It was unclear if this was due to the fact John Bercow, the speaker at the time, made it clear he wasn’t welcome to do so.
However, it didn’t appear to dampen Mr Trump’s excitement about his time with the Royal Family.
Speaking earlier this year, he described his state visit as “a fest” adding “it’s an honour… I’m a friend of Charles, I have great respect for King Charles and the family, William; we have really just a great respect for the family. And I think they’re setting a date for September.”
It is expected that, like Mr Macron, the pageantry for his trip this time will revolve around Windsor, with refurbishment taking place at Buckingham Palace.
Liverpool have retired the number 20 shirt in honour of Diogo Jota – the first time it has made such a gesture.
The club said it was a “unique tribute to a uniquely wonderful person” and the decision was made in consultation with his wife and family.
The number 20 will be retired at all levels, including the men’s and women’s first teams and academy squads.
A statement said: “It was the number he wore with pride and distinction, leading us to countless victories in the process – and Diogo Jota will forever be Liverpool Football Club’s number 20.”
The club called it a “recognition of not only the immeasurable contribution our lad from Portugal made to the Reds’ on-pitch successes over the last five years, but also the profound personal impact he had on his teammates, colleagues and supporters and the everlasting connections he built with them”.
Image: Jota’s wife joined Liverpool players to view tributes at Anfield on Friday. Pic: Liverpool FC
Image: Pic: Liverpool FC
Newly-married Jota died alongside his brother when his Lamborghini crashed in northern Spain on 3 July.