A social worker turned designer argues that a cold, ambiguous text message from the VA is what 'human-centred' really means in practice, and that care has to be the foundation of a system, not a patch applied afterwards.
Rachael Dietkus has taken a rather crooked career path: she started in art and design, switched to social work, campaigned to abolish the death penalty in Illinois, and served as an NGO delegate to the UN Human Rights Council.
The moment she got struck by lightning
Around 2013 she was at the U.S. Department of Veterans Affairs, running the healthcare programme for homeless veterans. At the time the government was talking up 'human-centred design'.
Then she heard someone from a nonprofit describe how they did research with homeless veterans, and her stomach dropped: these people walked into a community, extracted what they needed, and walked out untouched.
As a social worker she had been trained with practice standards, ethics, extensive documentation and peer accountability. Designers back then had none of that.
Why one text message terrifies people
Not long ago a colleague on the VA's digital team sent her a Reddit thread titled 'the scariest notification ever'. The screenshot was an official text: Your VA benefit decision letter is available. Tap to view.
Below it, veterans piled in: I panic every time, I feel sick when I get a text from the VA.
Dietkus's fix is simple: We have an update about your VA benefits. When you are ready, you can review your decision letter in the app. If you have any questions after reading it, we are here to help.
Design loves to preach comfort with ambiguity. But when you depend on a system for money or care, ambiguity is a disaster.
Draw your own boundary first
Her advice to designers is the idea of 'scope of practice', borrowed from medicine, nursing and social work: know clearly where your work begins and where it ends.
She also suggests keeping a care log: notice the person who says 'no problem, I will sort it' when you need to reschedule. Those small moments add up to what care looks like at work.
In the end, stop wearing 'human-centred' as decoration, and ask yourself when you last genuinely looked out for someone else.
Why it matters
The wording of a single text decides whether a veteran breathes easy or panics, and the same holds for every notice from a bank, a hospital or a tax office. A system's tone is not a detail; it is the one handshake between power and an ordinary person, and that handshake can be designed.
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