Why Health and Disability Systems Still Ask – “What Box Do You Fit In?”
At 2am this morning I was in a spiral of thoughts about therapeutic partitions, the sociology of professions… and a small orange square called Pezzettino.
Pezzettino is a surprisingly accurate metaphor for how navigating health and disability systems often feels for people with complex health and disability support needs.
If you don’t know Pezzettino, it’s a children’s book by Leo Lionni about a small square who believes he must be a piece of someone else – because everyone around him seems bigger, more complete, and more defined. Too often, people in our care systems are made to feel the same way: like they need to fit into someone else’s categories to be fully understood.
And when their needs don’t fit those predefined categories (especially in rural and regional communities) people are left behind. Not because professionals don’t care, but because the systems we rely on were never designed around real human need. They were built around labels, funding logic, and service boxes that struggle to recognise anyone who doesn’t fit neatly inside them.
So much of the time, the system asks: What box do you belong in?
Instead of: Who are you, and what do you need?
People as the Carriers of Their Own Care Story
Professionals are trained to view needs through the framework of their own knowledge box. But when our needs don’t fit neatly into that box, we’re referred on – to another service, another provider, another doorway, another file.
Like Pezzettino, people become the story-holders. They’re expected to carry their entire history with them and re-tell it over and over again, hoping the next person will understand where they ‘fit’.
The Hidden Work Required to Access Care
To survive in this environment, people are forced to become fluent in multiple systems at once. They have to learn the languages of funding, diagnosis, care, compliance, eligibility… the list goes on, and it’s all just to access support.
But here’s the thing: that work takes energy, confidence, time, and language. It requires skills that are unevenly distributed. Being able to self-advocate is a privilege, and it’s a privilege that many people simply don’t have.
When the system doesn’t accurately capture someone’s needs, the burden doesn’t disappear, but shifts. It’s left to families, support workers or the individual to pick up – if they can.
When Care Systems Erase Difference Instead of Supporting It
Let me make this concrete.
My ADHD looks completely different to my daughter’s. We’re two Pezzettinos with our own entirely different, wonderful, colourful combinations of blocks.
And yet, both of us are expected to contort ourselves into pre-shaped boxes — funding boxes, diagnostic boxes, service boxes — that weren’t designed for either of us.
How Missed Needs Accumulate Into Risk Over Time
When needs don’t fit in those boxes, they often slide off the table all together. The result is care plans that reflect categories rather than people.
For individuals, this means supports often miss what actually matters day to day. It might be a sensory challenge here, or a communication gap there.
But these needs aren’t separate boxes. They interact, change over time, and can accumulate into a decline in wellbeing that could’ve been prevented.
Left unaddressed, this decline compounds. Needs escalate and risk increases. Plans become reactive rather than preventative, families stretch themselves thinner, and practitioners fill gaps they don’t have the resources for. And people are asked to keep adapting themselves to systems that struggle to see them fully.
This is exactly the kind of compounding blind spot we need to design out of care systems, not manage around.
Why Most Care Softwares Follow Funding
In my work with rural health and disability providers, I see organisations investing heavily in tools that match care to funding, rather than actual human need. It’s often things like rostering software, billing systems, compliance dashboards, and efficiency trackers. While these programs can be useful, they miss a critical point:
Real, complicated, individual humans need something that helps them articulate what they need, in their words and colours, not in the systems black-and-white.
Designing Care Systems That Start With the Person
We’re building software that helps flip the system – away from boxes, and towards people. It’s software that enables individuals, families, and the people who support them to describe what actually matters, in their own words, and in ways that travel with them across service arms.
UNPLEXi supports multiple ways of capturing need over time — written reflections, voice notes, observations, emails, and day-to-day insights — so information doesn’t have to be flattened or translated to be taken seriously. The individual’s voice stays central, even as information is shared, reviewed, and acted on.
For organisations, this means seeing need sooner, responding earlier, and adjusting support before issues escalate. Instead of reacting only once things fall apart, teams can work with a living picture of change that highlights what’s emerging, what’s being missed, and where risk is building.
This isn’t a solo project
This isn’t something that can be designed in isolation.
If you’re working inside these systems – whether it be delivering care, coordinating support, navigating funding, or holding families together – I want to learn from you.
How do you manage this tension right now?
Where does the system help, and where does it make things harder?
What would it look like if care started with the whole person, not the box?
If this resonates, please reach out. Conversations like this shape how we build, and how we make this flip real.
Looking forward to hearing from you,
A, and the UNPLEXi team