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 child has died and another has been injured after a car was driven on to a sports pitch in Cumbria.
Police say they were called at 4.58pm to reports of a collision involving a BMW i40 and two children on a pitch at Kendal Rugby Union Football Club on Shap Road, in Kendal.
Cumbria Police say one child died, while the second is being treated by paramedics.
A man aged in his 40s has been arrested on suspicion of causing death by dangerous driving.
A spokesperson for Cumbria Police said: “Specialist investigators are at the scene and the area has been cordoned off as initial investigation enquiries take place.”
The force said the incident was not believed to be terror-related. Immediate family members of both children have been informed, it added.
In a post on its Facebook page, the club said it was “deeply saddened to confirm that an incident occurred today at Kendal Rugby Club.”
The post, attributed to club chairman Dr Stephen Green, continued: “Our thoughts are with their family and friends and we kindly ask for privacy for all involved at this difficult time.”
The club and its facilities are now temporarily closed while it cooperates “fully” with authorities, it added.
Tim Farron MP, whose constituency includes Kendal, posted on X: “This is devastating, utterly heartbreaking news. I’m praying for the children and for their families and friends.
“Our community in Kendal is stunned and in mourning.”
A man has been convicted of drugging and raping 10 women in London and China between 2019 and 2023.
Chinese PhD student Zhenhao Zou, 28, filmed nine of the attacks as “souvenirs”, and kept a trophy box of women’s belongings, jurors in his trial were told.
Warning: This article contains details of sexual offences
He was accused in court of drugging and raping three women in London and seven in China between 2019 and 2023.
Jurors at Inner London Crown Court found him guilty of 11 charges of rape against 10 women, including two who have been identified and another eight who have yet to be traced.
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Moment police arrest student guilty of rape
The mechanical engineering student was also convicted of three counts of voyeurism, 10 of possession of an extreme pornographic image, one of false imprisonment and three of possession of a controlled drug with intent to commit a sexual offence, namely butanediol.
He was cleared of two further counts of possession of an extreme pornographic image and one of possession of MDMA with intent to commit a sexual offence.
Image: The trial heard Zou kept a ‘lost property box’ full of women’s belongings. Pic: Met Police
The jury has not reached verdicts on four counts of possession of drugs with intent to commit a sexual offence.
Zou – who first moved to Belfast in 2017 to study mechanical engineering at Queen’s University before moving to London in 2019 – showed no visible reaction as the verdicts were read out in court.
Catherine Farrelly KC, prosecuting, told jurors during the trial that Zou “presents as a smart and charming young man” but is “also a persistent sexual predator; a voyeur and a rapist”.
Image: A discreet camera belonging to Zou. Pic: Met Police
Zou, who also used the name Pakho online, befriended fellow Chinese students on WeChat and dating apps, before inviting them for drinks and drugging them at his flats in London or an unknown location in China, the court heard.
The jury heard how he would secretly film his attacks using a mobile device and hidden cameras, and was shown evidence found on SD cards at his accommodation of him raping unconscious women in London and in China.
Senior Crown Prosecution Service prosecutor Saira Pike thanked the “incredibly strong and brave” women who came forward to report his “heinous” crimes.
“Zou is a serial rapist and a danger to women,” she said.
“In some instances, we have not been able to identify Zou’s victims. Without knowing who these women are, we have not been able to support them through a deeply distressing period of time.
“We have always been determined to seek justice for both the unidentified and identified victims in this case.”
A British man has been jailed for 19 years after a Russian court found him guilty of fighting for Ukraine in the country’s Kursk region.
James Scott Rhys Anderson, 22, had been charged with terrorist and mercenary offences and was found guilty after a closed trial.
The court said he was to serve the first five years of his sentence in prison and the remainder in a penal colony.
In the trial, a Ukrainian soldier from the same unit was questioned as a witness.
Ukrainian troops broke across the border into Kursk region on 6 August last year.
They still hold some territory there seven months later, despite attempts by Russian forces to force them out.
Investigators accused Anderson of illegally crossing into Kursk in November as part of an armed group that committed unspecified “criminal acts against civilians”.
Russian state media published video showing him being led in handcuffs and locked in a cage of the kind where defendants in Russian court cases are placed.
It apparently showed Anderson saying he had served in the British army from 2019-2023 before deciding to join the foreign legion of Ukraine’s armed forces.
Early on in the war, Ukraine’s authorities said more than 20,000 people from 52 countries came to Ukraine’s aid.
Since then, the number of foreign fighters in Ukraine’s military has been classified.