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The Triage Trap: Why do we defend the systems that rely on our crisis?

Phased
I wanted to share some thoughts not to focus on frustration, but to help us constructively look at why navigating these systems can feel so incredibly exhausting. By gently unpacking the core mechanics of the structures around us, we can stop spending our finite energy trying to fit into spaces that weren't built for us, and instead start looking at how to cultivate a genuine way forward.
Following on from the discussion regarding the structural limitations of the NHS, I’ve been reflecting on how the concept of "triage"—which we normalised as an acceptable operating model—actually impacts almost every other major pillar of neurodivergent life.
Triage is, by definition, a battlefield necessity born out of extreme scarcity. It was designed to sort the immediately dying from those who can wait. When we carry this wartime mindset into peacetime society, it creates a perverse infrastructure that can actively punish proactive management and force neurodivergent people into visible crisis just to receive basic human adjustments.
From my perspective, we see this identical "battlefield triage" model playing out across three major areas:
1. The Education System: Triage at the School Gate
Because school budgets and specialized staff are under permanent scarcity, resources (like 1-to-1 support or sensory spaces) are strictly rationed. To get help, a child often must be in a state of visible, disruptive crisis—acting out or school-refusing. Autistic children who default to internalizing their anxiety, masking, or quietly slipping under the radar are pushed to the bottom of the pile because they aren't "disrupting the battlefield" of the classroom. Their slow-motion burnout is ignored until they completely collapse.
2. The Workplace: Reactive HR, Not Proactive Design
Corporations heavily market their "neuroinclusive" credentials, but their operational models remain entirely crisis-driven. Offices and workflows are rarely designed with sensory sensitivities or executive dysfunction in mind from the outset. Instead, the corporate triage machine only kicks in when an employee hits a breaking point—resulting in a performance failure or prolonged sick leave. Only when it becomes a financial or legal risk does HR step in to patch things up, rather than building a peacetime environment where they could have thrived from day one.
3. State Support and Benefits: The Deficit Trap
The entire infrastructure for disability support operates on this exact same battlefield mindset: prove to us how broken you are today so we can decide if you qualify for support. It demands that we describe our absolute worst, most dysfunctional days, stripping away the context of dynamic disability. If an autistic adult manages to scrape by through immense personal effort and preventative self-care, the system views them as "healed" and strips the safety net away—inevitably triggering the very crisis they were working to avoid.
The Solution and the Psychological Barrier
Many of the posts I read across this forum already describe these exact battles in heartbreaking detail. We know the system is blind to slow-motion, chronic challenges. But when we talk about solutions, we often fall into a trap. We instinctively adopt the establishment's language—arguing about tax hits, macroeconomics, or why radical change "can't be done."
In a way, it can feel like turkeys voting for Christmas. It is a known psychological defense mechanism: it is far less painful to believe that the system is broken because of "budgets" or "poor funding" than it is to confront the harsh reality that the current design relies on a level of structural spite and hostility toward neurodiversity. If we convince ourselves that a better, bespoke world is an impossible luxury, the mistreatment we endure right now becomes easier to accept.
This isn't about wallowing in despair; it is about accurately identifying the problem so we can finally start talking about a realistic way out. But if we are ever going to find a sustainable path forward, we have to stop accepting the excuses of a crisis-driven model that treats our well-being as an afterthought.
How do we, as a community, step away from this cycle of accommodation and survival? If we were to stop trying to adapt to frameworks that are simply working exactly as they were structurally designed to, what does a genuinely supportive, proactive environment look like to you?
Parents
  • Thank you both,   and . Yours are I believe very illuminating additions to the conversation, especially with Alexa sharing that firsthand insight into how the machinery of HR actually operates.
    In a way, you have both perfectly illustrated the mechanics of the "triage trap" from two sides of the same coin.
    Alexa, your experience as an HR officer highlights the exact structural flaw I was pointing out. When the legal definition of a "reasonable adjustment" is strictly capped by the requirement to bring a neurodivergent person up to the exact baseline of a neurotypical worker, the system is operating entirely on a deficit model. It treats neurodiversity as a personal "fault" that needs to be patched up to fit an unyielding corporate mold, rather than valuing the unique cognitive styles, objective problem-solving, or deep analytical skills that an autistic individual naturally brings to the table.
    Iain, this connects directly back to your analogy of the workplace being like the Sahara Desert. The Sahara is a fixed force of nature and geography. But corporate workflows, rigid HR benchmarks, and physical office spaces are not natural phenomena—they are conscious choices. When Alexa points out that our world was simply not built for these things in the past, she is entirely right. But we do not have to accept that past design as our permanent future.
    When a system dictates that we are a "hassle," a poor "return on investment," or that we must simply "cope better" within an architecture that was explicitly designed without us in mind, it is choosing a path of structural exclusion.
    Alexa's point that some shops simply cannot afford lifts or ramps is exactly why relying on individual employers to voluntarily accommodate us—one crumb at a time—is a failing strategy. It is precisely why pouring more money into the "broken bowl" of existing frameworks doesn't work. If the baseline architecture itself is fundamentally incompatible with neurodiversity, the answer isn't to try and "cope better" in the desert; it is to start talking about how we build entirely parallel, proactive structures designed for peace and sustainability from the ground up.
    Maybe the desert can be brought into bloom?
  • in reply to Phased
    Phased said:
    When a system dictates that we are a "hassle," a poor "return on investment," or that we must simply "cope better" within an architecture that was explicitly designed without us in mind, it is choosing a path of structural exclusion.

    I think it is less the system that is to blame here and more the people within it.

    The managers and team members that are tasked with including the neurodivergent person are rarely informed or have bias and are often poorly suited to helping those with special needs.

    If we can find a way to raise awareness and tolerance of us then we have a chance for these systems to be actively of use.

    This is why I think we are at least a generation away from it starting to work - people are just so low to accept the differences of others.

    A great topic by the way!

  • in reply to Iain
    Thank you,  Iain   I’m really glad you’re finding the value in exploring this together.
    I completely agree with you that the individuals—the ground-level managers and teammates—are the ones who ultimately deliver the day-to-day hostility or exclusion. But I would argue that this is actually the ultimate, built-in design feature of the "triage trap" itself.
    In sociology, there is a known phenomenon where large, cost-cutting institutions intentionally build in "sacrificial structures" at the local level. By under-resourcing middle managers, leaving guidelines intentionally ambiguous, and creating impossible workloads, the overarching architecture perfectly protects itself. When a neurodivergent person falls through the cracks or faces a performance review failure, the system can simply shrug its shoulders and blame the individual. It says, "That was just a failure of local training or a lack of individual awareness,"
    rather than admitting the entire framework is working exactly as it was structurally designed to do: to filter out diversity in favour of standardised compliance.  I have observed and experienced it several times over.
    Furthermore, as long as the system forces those managers to operate in a permanent wartime triage mode, expecting "awareness" to save us is a peacetime luxury. A manager under intense crisis pressure to hit corporate targets will almost always default to viewing any deviation from the neurotypical norm as a barrier to immediate survival. The system's crisis-driven nature forces the people within it to act with hostility, regardless of their personal intentions.  For what it's worth I still have quite a degree of compassion for such people who I think have hurt neurodivergent people because they are put in an impossible position and don't have the insight, strength or means to withstand it.
    If we wait a generation for neurotypicals to slowly unlearn their biases out of the goodness of their hearts, we will lose another generation to burnout and systemic exclusion. We cannot wait for the people to change the system; we have to change the architecture so that the people are forced to adapt to us.
    We don't need decades to change human hearts. There are already historical precedents—from the Independent Living Movement to strategic public law challenges—proving that when an organised community stops asking for permission and instead builds its own parallel, proactive networks, the state is eventually forced to follow their blueprint.
  • in reply to Iain
    Thank you for continuing this deep dive,  . You have asked one of the most critical questions of all: How do we fund this, and does forcing an architecture actually change human hearts?
    Let's address the maths first. You mentioned a cost of tens of billions for a return of "a few million." But a landmark joint report by the Mental Health Foundation and the London School of Economics (LSE) indicates that unmanaged mental health and hidden disability challenges cost the UK economy at least £117.9 billion every single year in lost productivity, systemic crises, and frontline strain. We are already spending tens of billions—we are just spending it on the back-end patching up casualties in A&E, processing long-term benefits, and absorbing workplace attrition. As I highlighted on another thread, moving this to a ring-fenced statutory body isn't creating a new cost; it is relocating existing, massive economic waste into proactive, front-end prevention.
    Regarding your observation that forcing behavioral change only creates resentment and takes a generation to stick—you're right to call out psychological resentment. Where we differ slightly is not on whether this resentment happens, but on what causes it.
    When a single neurodivergent employee has to fight for a "reasonable adjustment," and management forces their immediate colleagues to alter their behaviour to accommodate them, it creates a hyper-localised friction. The colleagues don't understand the "why," they see it as an unfair disruption to their baseline, and the autistic individual is left carrying the social cost of that resentment. I know this from personal experience.
    Worse, media outlets and bad-faith political actors know exactly how human psychology reacts to this localised friction. They deliberately employ tactical disinformation to weaponise that resentment. They understand how architecture influences people, and they actively exploit it to manipulate public opinion—framing simple human adjustments as an intrusive "hassle" or a special privilege. We end up with the tragic consequence of trying to force inclusive behaviour inside an architecture that remains inherently neurotypical, leaving our community exposed to systemic hostility.
    My argument for changing the architecture is not about legally forcing individuals to change their personal attitudes via top-down mandates. It is about shifting the default environment so that the friction never occurs in the first place. When the default shifts, history shows that attitudes naturally follow the architecture. If we wait for individual education to change human hearts before we change the architecture, progress stalls forever.
    Look at the Independent Living Movement of the 1970s. Disabled individuals didn't waste decades trying to educate local authorities or wait for society to feel empathetic. They built their own parallel, peer-led infrastructure, proved it worked, and aggressively forced the state's hand. Today, the entire philosophy of direct payments and personalised care is standard practice. The architecture forced the compliance, and the societal attitude followed.
    Look at the Autism Act 2009. The National Autistic Society didn’t wait for a generation of civil servants to slowly unlearn their biases. They co-authored and pushed a specific Private Member's Bill directly onto the legislative floor, legally mandating local authorities to provide services. The law forced the behavioral shift, which in turn accelerated the very public awareness we see today.
    Maybe there is an argument to say these are "top-down" mandates, but the crucial difference is that these weren't put together by some bureaucrat who told the public "this is what you must do, now get on with it". The Autism Act and the frameworks of the Independent Living Movement were completely co-authored and driven by neurodivergent and disabled people themselves. They weren’t designed by the state to police people; they were designed by the community to dismantle the state's triage barriers. They forced the state to adopt a blueprint that had already been proven to work at the grassroots peer-led level.
    There is a massive psychological difference between an edict that forces you to change your personal behavior for an individual and an edict that changes the permanent environment for everyone.
    You might look at the Autism Act 2009 or the Independent Living Movement and point out that they generated significant systemic resentment anyway. And you’d be right. But look closely at why that resentment happened: it didn't come from everyday people suddenly hating inclusion. It was manufactured by two distinct systemic failures.
    First, the state passed these laws as 'unfunded mandates'—leaving a structural disconnect where local authorities were legally forced to build new corridors of architectual change for resolving unmanaged health and disability challenges  without being given the concrete financial bricks to do so.   Leaving middle managers to fight over crumbs. Second, bad-faith media actors deliberately weaponised that artificial scarcity, telling the public that statutory rights for disabled and neurodivergent individuals were 'special privileges' being taken out of the taxpayer's pocket. The resentment wasn't caused by the architecture itself; it was caused by the system deliberately underfunding the building project and letting the occupants fight over the layout.
    You are entirely right that when a middle manager—who is already drowning in an impossible triage system—is told by upper management to "adapt to an ND colleague," it creates resentment. But that resentment doesn't happen because the manager is evil; it happens because the architecture is still broken. They are being asked to accommodate diversity inside a system that actively punishes anything outside the standardised norm.
    We don't need a generation to gently educate people while our community burns out. We change the environment, we use strategic public law to make structural hostility financially volatile for the state, and we write our own blueprints into legislation. When the building changes, the people inside it naturally learn how to walk the new corridors.
Reply
  • in reply to Iain
    Thank you for continuing this deep dive,  . You have asked one of the most critical questions of all: How do we fund this, and does forcing an architecture actually change human hearts?
    Let's address the maths first. You mentioned a cost of tens of billions for a return of "a few million." But a landmark joint report by the Mental Health Foundation and the London School of Economics (LSE) indicates that unmanaged mental health and hidden disability challenges cost the UK economy at least £117.9 billion every single year in lost productivity, systemic crises, and frontline strain. We are already spending tens of billions—we are just spending it on the back-end patching up casualties in A&E, processing long-term benefits, and absorbing workplace attrition. As I highlighted on another thread, moving this to a ring-fenced statutory body isn't creating a new cost; it is relocating existing, massive economic waste into proactive, front-end prevention.
    Regarding your observation that forcing behavioral change only creates resentment and takes a generation to stick—you're right to call out psychological resentment. Where we differ slightly is not on whether this resentment happens, but on what causes it.
    When a single neurodivergent employee has to fight for a "reasonable adjustment," and management forces their immediate colleagues to alter their behaviour to accommodate them, it creates a hyper-localised friction. The colleagues don't understand the "why," they see it as an unfair disruption to their baseline, and the autistic individual is left carrying the social cost of that resentment. I know this from personal experience.
    Worse, media outlets and bad-faith political actors know exactly how human psychology reacts to this localised friction. They deliberately employ tactical disinformation to weaponise that resentment. They understand how architecture influences people, and they actively exploit it to manipulate public opinion—framing simple human adjustments as an intrusive "hassle" or a special privilege. We end up with the tragic consequence of trying to force inclusive behaviour inside an architecture that remains inherently neurotypical, leaving our community exposed to systemic hostility.
    My argument for changing the architecture is not about legally forcing individuals to change their personal attitudes via top-down mandates. It is about shifting the default environment so that the friction never occurs in the first place. When the default shifts, history shows that attitudes naturally follow the architecture. If we wait for individual education to change human hearts before we change the architecture, progress stalls forever.
    Look at the Independent Living Movement of the 1970s. Disabled individuals didn't waste decades trying to educate local authorities or wait for society to feel empathetic. They built their own parallel, peer-led infrastructure, proved it worked, and aggressively forced the state's hand. Today, the entire philosophy of direct payments and personalised care is standard practice. The architecture forced the compliance, and the societal attitude followed.
    Look at the Autism Act 2009. The National Autistic Society didn’t wait for a generation of civil servants to slowly unlearn their biases. They co-authored and pushed a specific Private Member's Bill directly onto the legislative floor, legally mandating local authorities to provide services. The law forced the behavioral shift, which in turn accelerated the very public awareness we see today.
    Maybe there is an argument to say these are "top-down" mandates, but the crucial difference is that these weren't put together by some bureaucrat who told the public "this is what you must do, now get on with it". The Autism Act and the frameworks of the Independent Living Movement were completely co-authored and driven by neurodivergent and disabled people themselves. They weren’t designed by the state to police people; they were designed by the community to dismantle the state's triage barriers. They forced the state to adopt a blueprint that had already been proven to work at the grassroots peer-led level.
    There is a massive psychological difference between an edict that forces you to change your personal behavior for an individual and an edict that changes the permanent environment for everyone.
    You might look at the Autism Act 2009 or the Independent Living Movement and point out that they generated significant systemic resentment anyway. And you’d be right. But look closely at why that resentment happened: it didn't come from everyday people suddenly hating inclusion. It was manufactured by two distinct systemic failures.
    First, the state passed these laws as 'unfunded mandates'—leaving a structural disconnect where local authorities were legally forced to build new corridors of architectual change for resolving unmanaged health and disability challenges  without being given the concrete financial bricks to do so.   Leaving middle managers to fight over crumbs. Second, bad-faith media actors deliberately weaponised that artificial scarcity, telling the public that statutory rights for disabled and neurodivergent individuals were 'special privileges' being taken out of the taxpayer's pocket. The resentment wasn't caused by the architecture itself; it was caused by the system deliberately underfunding the building project and letting the occupants fight over the layout.
    You are entirely right that when a middle manager—who is already drowning in an impossible triage system—is told by upper management to "adapt to an ND colleague," it creates resentment. But that resentment doesn't happen because the manager is evil; it happens because the architecture is still broken. They are being asked to accommodate diversity inside a system that actively punishes anything outside the standardised norm.
    We don't need a generation to gently educate people while our community burns out. We change the environment, we use strategic public law to make structural hostility financially volatile for the state, and we write our own blueprints into legislation. When the building changes, the people inside it naturally learn how to walk the new corridors.
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