Accountability Without Autonomy: Rethinking Behavioral Health Leadership
By: Jamelia Hand MHS CADC CODP I “I felt the weight of responsibility, but never the freedom to decide how to respond.” That’s how Lisa*, a middle manager in a community-based substance use treatment program, described her daily reality. She oversaw operational departments including client engagement and staff scheduling, with ever-evolving policies. Yet, despite the heavy burden, every decision, from hiring relief staff to adjusting therapy group formats, required approval f





