You're listening to Speaking of Design, bringing you the stories of the engineers and architects who are transforming the world one project at a time. Today, we bring you another episode of a special podcast series on behavioral and mental health called Listen, Mental Health Matters.
As part of this series, Brian Giebenk, behavioral and mental health practice leader at HDR, visits some of the world's leading health care providers for candid conversations about the challenges they face and the opportunities to transform the patient and caregiver experience.
I'm Brian Geebing, and I hope that by listening, the series helps us consider new perspectives in our quest to create transformational mental health facilities that improve the quality of life for individuals and families and promote a shared sense of community. And now Brian's conversation with Nick Giuliano, president and CEO of Radius, a nonprofit serving youth and families in Omaha, Nebraska. So, Nick, thank you for being here today in Omaha, Nebraska, and it's a beautiful sunny
day here in December. Really appreciate your time, Nick, joining us today for the podcast. We are fortunate to work with you on the design of the new radius of the residential treatment center. Wanna hear a lot about that, but first thing, I would love to hear a little bit about you, about Nick Giuliano. So if you don't mind sharing a little bit about your background and your career path and how you got to where you are.
Well, Brian, thanks for this opportunity. It's great to talk with you, and we're very pleased. I was telling you before we started how this facility has worked exactly how we intended it and how it was designed. So a little bit about me, I was really lucky
before coming to Radius. I spent twenty three years at Boys Town, and that afforded me a great opportunity to receive world class training in working administratively and with youth and families as well as seeing firsthand how to develop new programs and implement effective programs across the continuum, and that includes education and residential care and in home services and clinical
services. And so, as I arrive here today with Radius, I've been fortunate to have all that experience and a great team of people who have very similar experience driving the mission of Radius. You mentioned twenty three years of Boys Town. Yes. Was was that kinda where you started your career? It was. And I started six months after graduating college. And so this month marks my thirtieth year in the
field. Okay. All in the nonprofit space and all working with youth and families involved in the child welfare and juvenile justice system. And so it's really all I've known, and I've definitely benefited from a lot of that experience. Learned a lot along the way as well. Absolutely. What drew you into this? You mentioned six months out of school when you jumped into the Boys Town network and now you're here.
What brought you into this? What was behind Nick wanting to join Boys Town or be a part of this nonprofit organization? Well, growing up in Omaha, I was very familiar with Boys Town. Okay. And it's a world known organization. And I think like a lot of people at that time, I had graduated. I had an undergrad degree in psychology. Wasn't sure what I wanted to do. Thought I might wanna
work with young people. And so when you're in Omaha and you're wondering if you might wanna work with young people, Boys Town's the place to go. So, honestly, it was a try it out. Let me see if I like it. And what I was told by people was go get a job working with youth. You'll know immediately if it's for you or not. And so right out of the gate, I really enjoyed it. It was challenging and rewarding, and I just kinda stuck with it. And eventually, it became
a career. That's how I got started. So twenty three years at Boys Town. Now you've been at Radius for the last seven years? It will be six in June. Six years. Six years here at Radius. Yeah. Can you give a little bit of an overview of what Radius is and who you serve and what the mission is of the program? Absolutely. So the mission of Radius is to empower youth and families to reach their full potential through community engagement and trauma informed education, social, and behavioral
health services. So the way we do that is by providing four core services. So that's residential care. We have 24 beds for young people to live with us here. Education. So they're working towards a high school diploma, and we've had four young men actually receive their high school diploma here. In home family services, which is really important to work with the families of the young people while they're here.
And a very unique partnership with Charles Drew Health Center, which in Omaha is a federally qualified health centers. And so the youth who live here go right next door and receive physical and behavioral health services. And that's really unique and powerful because it's also a freestanding community facing location. So anyone from the community can access that. When the youth leave Radius, they can return. They can keep their same doctor, their same therapist.
They're doing family work. And so that continuity of care is really, really important because once you develop that relationship, we want that to continue when they go home. So as far as the youth that we serve, historically, youth by the way, all of the youth here are involved in our local juvenile justice system. So they are on juvenile probation. They've been evaluated and court ordered here by a juvenile court judge for rehabilitation.
And that's really important to know because the complexity of their needs include some legal involvement, certainly physical health care needs, potentially mental health and substance use needs, certainly a need to continue their education, learn new skills, and their families are in very difficult situations. There's a lot of instability and challenges with
their family. And so, historically, the young men at Radius have had to go very far away from Omaha to places like Utah and Arizona and Ohio. In fact, if we were not here today, our young men would be there. And so our goal is to keep our Omaha youth here locally, get the help that they need because nobody should have to go away. And really, long term success and healing needs to occur in the community you're gonna live in with your family so we can work together on that. That
can't be done from a distance. And so that's really the unique need that we meet here locally. We're seeing that across the board in our work on the design side. We're seeing that that it's so important that we have places for kids where they're at because a big part of behavioral mental health care is that the connection with family, the connection with the community. Yeah. So when you leave, if you're removed from that, you might receive outstanding care, you might be receiving
the world's best care. Right? But you're kind of receiving that care in a a palace. Right? For lack of a better word. Right? And then you're sent elsewhere once you've recovered or you're to a point where you no longer need the services. You're sent back home where you're completely disconnected from it all. Yep. It's amazing that the radius is bringing that care right where it's needed, that model, that treatment model right where it's needed. We're grateful to be a part of
it, and you summed that up perfectly. And what we see from our the young people who've been here and been successful is that their families stay connected from day one, and that's both with visits here to radius, frequent structured home visits to work on their skills in the environment they're gonna live in, plus thousands of hours now in nineteen months of community events where our young people are out in the community, interacting with the community, doing community service,
experience in our community, but having an opportunity to practice, so to speak, and work on the skills that we hope they'll have for long term success. And we also happen to be located in the community where the bulk of our youth are from. And so even within the Omaha community, this specific location is intentional, so we're nearby as well as we recruit the bulk of our staff from this community. So our staff are also aware of the community our kids are from,
aware of their situation. So that relational piece drives the other programs and services. And you mentioned a thousand hours of community service. That's fantastic that the kids are involved in community service and involved in the community while they're within your program. I imagine that's also raising
awareness within the community. People are seeing this engagement, this involvement in the community, and it's probably, hopefully, kind of destigmatizing maybe the whole issue of behavioral health care, but just raising awareness in general about what you do and the amazing service that you provide for the community. That's a great point. It really does get to that stigma. And those thousand hours aren't just community service. It's routine activities in the community. We'll go
to local events. We have a very unique, powerful family dinner night once a month where we go to a community location with the Radius youth. Their families and friends are invited. We also invite in community partners because the specific work Radius does that I described is provided directly by us, but there's another, their trusted relationships in the community. And so we invite those partners in to get to know our families, to provide other resources.
And so as we go about that, absolutely not only reduces the stigma of getting help, particularly mental health, which is strong. But there is a lingering stigma about justice involved youth that for many, they see their law violations first and sort of contemplate whether they deserve the kind of care that they need. We have inverted that philosophically. They are children first and they have complex needs. We will help them and their families. And, yes, they also happen to be justice
involved. So there is accountability. They have probation officers. They have a court. Community safety is top of mind to make sure that while we're working with them and they return home, they're safe in the community and our community is safe. But we have to start with the person, the child and the family, and that further helps to reduce that stigma.
If you spent time here and talk to our guys, you would leave that interaction having talked to young people, not having walked out the door saying, oh, I just talked to a bunch of guys on probation. It's very powerful. But the community needs to see that. Right? And if that's the point of us being out there. It might be a good segue into the next question here about having key moments or a series of moments that define who you become
and what you do. Is there a particular moment that you can you can point to or look at that really shaped the idea of Radius and shaped it into what it is today? Yes. Several key moments. The first of which was the vision of local philanthropists who investing in our community for decades in education and after school program and mentoring and mental health continued to look at who was not being served or who was not being served
here. And so that vision, that's a community changing moment because the leaders stepped up and said, this is the next group that we're
going to help. The next moment was development of our local advisory group, which did include those philanthropists, health care experts, law enforcement, including a deputy chief from Omaha police, juvenile court judges, probation officers, maybe most importantly, a young person who himself had experienced our local system and had to go far away, and the parent of two now grown boys who had experienced our juvenile justice system
and they had gone away. So that was sort of the next moment that momentum carried for eighteen months before there ever was a radius critical mass. And then finally, obviously, with the concrete vision and planning, those same philosophers with unbelievable generosity stepped up and funded the entire project. So, Radius operates today owning our building and our land with no debt, and that's solely thanks to the generosity of Omaha's philanthropic community. Community.
And just driving around town, you noticed the philanthropic community is really strong here. And I I think Radius has experienced that. And so there's I think Omaha has really great opportunities for philanthropic initiatives that are serving very, very important and meaningful opportunities in many different ways. And a lot of them seem to be very focused on community and and finding the gaps and filling
those gaps. I know that you've talked a little bit about what you do and what you're doing and as far as what you're striving to provide. Is Is there anything specific that you wanna address about? What are you striving to provide in the community for Radius that you haven't already mentioned? What we're striving to provide is helping youth and families get to that point in their life so they reach their potential. Right? And for young people age 12 to 18, top of mind is we wanna continue your
education. We'd like you to graduate high school whether it's a radius or when you return to the community. We want you to have the skills to be employed. And as you move into adulthood, we want you employed. We want you safe, of course, no longer having law violations because that's now part of your past, not your not your future. And in that then, helping the families strengthen themselves and also connect to others in the
community. So that's the long game in that we have productive citizens because communities get stronger Mhmm. When people are safe and at home and employed and are able to reach their own goals. So that's everything we do is is tailored to that even though for a period of that time, they're going to live with us, and that's to keep them safe and sort of accelerate that process. You're doing such amazing work, and I'm sure it doesn't come easy. I'm sure there are challenges.
What are some of your biggest roadblocks that you face? And I think a lot of our listeners would really learn a lot from this question because of everybody in the mental health space and the behavioral health space is trying to solve this epidemic. Right? Yeah. Especially around children and youth mental health. What are some of the challenges you face? Are you able how have you been able to pivot and move some of
those initiatives forward? So we address one of the big ones which we all face, which is that stigma about mental health and mental health services and then the broader stigma for our justice involved, youth and families. We have to tackle that with continued education and advocacy. Mhmm. And sometimes when we have parts of our community or parts of the policy world that are really kind of antagonistic to what we're doing, we just have to refocus on the mission
and keep the task at hand. So that's the first one. The second one is workforce is obviously a challenge for all of us. Because with the innovative programs we have and we utilize three different evidence based practices, we ask a lot out of our staff. You know, you have to have a personal commitment and a draw, but then we ask a lot out of their technical skills through our high quality training to be able to deliver services that are not only relational.
Relationships are very important, and they're the foundation of everything, but the actual practices that have been shown to be effective. And I think anyone doing this work, we been shown to be effective. And I think anyone doing this work, we struggle with workforce because we need more dedicated people that are willing to learn and grow. And our youth are a challenging population to work with. The other thing in programs like ours is, you know, we talked about that long term goal.
Often, we don't get to see the realization of that long term goal. Right? They're with us for a period of time. We actually do family work. You know, one of the things that makes us unique is we start family work day one and we work intensively with the family, the entirety of the youth stay. And then when they return home, we continue to work with them. You know? So if the youth is here twelve months, that could mean we're working with
the family for fifteen months. And you can have a lot of positive change and effect on people in fifteen months. However, the long term goal, we don't always see firsthand. And so I think anyone in this field, we have to take those moments. I had one the other day when a young man came up to me and was very proud here to earn three high school credits, and he was progressing toward a high
school diploma. He had been in detention for two years and while he had access to education, was not as motivated in that setting because he couldn't see himself in the community. So we take those moments. When this weekend, we had nine families here having family visits. And that's parents and siblings, an aunt and uncle. We've had three generation visits here where, again, if they have been detained or they've been in their location, they haven't seen their family for months and years.
And they have that moment, and they are talking, and they're sharing a meal, and they're communicating, and there's joy. We have to take those moments. Right? Because the work we're all doing to accomplish those long term goals is very difficult. Probably the other roadblock we face I mean, funding is always an issue in this work and probably for all of the listeners because very few funders will pay the entire cost for quality programs. And so, again, we rely on generous donors,
and we'd have that support. But also in in the policy realm, you know, community safety is an important topic, and it's also a polarized topic. And so when you're working with young people who've been involved in the community with law violations, they've been involved very frankly in creating some safety issues in
our community. Again, being able to get everyone to refocus on that happened and there is accountability and the path forward is not to dwell on that, but to dwell on the healing and the treatment and the complexity of those needs. That is a challenge everywhere. It's certainly challenge here in Nebraska because, you know, I have an 81 year old mother and she watches the news. And if she
feels unsafe, that's a challenge. And so that's a barrier for us because, you know, at times, it slows our progress because the young people we have are all deeply involved in the justice system. So, again, we have to educate, we have to advocate. And as we have a little more experience, so we've been operational for nineteen months, we'll have some success stories to share. Right now, with a small number of youth, we don't have the kind of stories that can change hearts and minds and really see
these kids at different light. So that's that's something we grapple with and I'm sure everybody else does. I think those are really good examples of some roadblocks. And I think you've done a tremendous job pivoting. And I think you've mentioned that you've been in operation for, is it eighteen months? This is our, I think, our nineteenth month. Nineteen months in operation Yeah. And so you've seen a lot of
success during that time. Yeah. And you'd mentioned previously you've been part of Radius for six years which is I think really important to think about all of the upfront work that you did to get to the point of even building a space and then and then creating the space for the residential treatment program.
We talked a lot about community engagement with the with the kids out in the community, but I'm sure a lot of community engagement and a lot of raising awareness within the community and a lot of upfront work went into where you're at today. Can you talk a little bit about your approach and the importance of the community engagement and getting everybody behind it whether it was philanthropy or really critical, particularly our location. We are in an urban core.
In fact, we are in a neighborhood. So adjacent properties are private homes. And so you can imagine when the announcement was made that there would be, we weren't called Radius then, that there would be a program like the one we're operating literally right in somebody's backyard. There's legitimate concern. And so we took a very open approach and a slow thoughtful approach in the very early days. Even before we had all the details, that's a little risky because you get asked a
lot of detailed questions. And if you don't have answers, it tends to make people uneasy. But we took that risk because everybody felt our advisory board, eventually, the the board of Radius and myself, that people needed time to process and needed time to talk. And whatever emotions were attached with our future presence was valid.
And I've learned along the way, giving people an opportunity to speak even if they're not things you wanna hear is really important then to get down to the details and how will this work and how we work together. So we had a series of community meetings right here on this property next door. As you can imagine, there was a lot of energy in the room. We listened very intently.
We shared what we knew, and we were also honest about what we didn't knew because because we had not even started building design at that point in time. But we continued that relationship, and what we found over time was we moved into the neighborhood association, which is more representative of the actual individuals who were in this area. And while they had concerns, they routinely comment at this point, we're a year into a conversation. And they would have meetings and myself and
one of my colleagues would show up. And every time we came to meeting, they would say, I can't believe you keep coming to our meeting. Why would you do that? We always yell at you. We're always mad at you. And I said, we're gonna work together. We're gonna be neighbors. I'm committed. So like any relationship. Right? You need time
Mhmm. In a space together. And then as we worked along with support from the local city council member and a local faith community who's involved in neighbor association, we really got down to what are your key concerns? There were 10 items. We were able to address eight of them. They want an additional street light down the street, and the city of Omaha disagreed. And there was one other item, but we were able to deliver on eight of the 10 concerns.
We took another step forward. And then every step of the way, we would share with them design documents. They got to tour this facility at various points ahead of the public and ahead of media and elected officials little by little by little. The last time we had a neighbor association meeting here, the two most vocal residents who I'm now friends with asked if they could work here here or volunteer and were brought to tears as we were sharing some of the successes of the young people
that we're working with. And so we have to earn that every day like every relationship. But we took a very thoughtful approach, and there was no hurry to it. And had we run into significant barriers, which thankfully we didn't, we likely would have paused the project. Mhmm. That's how important it was. And so I think when you're doing this kind of work, particularly in uncomfortable moments. Mhmm. It makes you second guess a little bit, but we stayed the course and it's it's paid
great dividends. When we had the neighbors in the first time tour the facility, one of their concerns was how the facility looked from their backyard. And also, we have a fence around our perimeter to identify our property. And all along, they were concerned about the fence. The fence will have razor wire. It will not. It will be ugly. And first time we had the neighbors and we walked out back and I said, what do you think about
the fence? And again, the one most vocal neighbors looking 50 yards away said, said, I can't even see the fence. Is there a fence there? And the other neighbor laughed and said, yeah. That was the point. Remember, they talked about how the fence would look nice. Yes. It defines the property, but it blends in the neighborhood. So that's a small example of the physical space, but it speaks have been Would have been nice if they knew what
it looked like before. But when you were in these early conversations, I don't even think you had a conceptual design at that point. Did not. So it was all when you say fence and you say secure. Right? Secure and fence Yeah. Immediately got a razor wire and Yeah. Ugly. Right? But there are very very elegant solutions that basically disappear with the fencing and I think the same goes the building in general when you're driving down the street here it fits in with
the neighborhood. It's at the right scale. It's elegantly understated. I imagine that's very appreciated too by the by the community. It is appreciated. And credit to HDR for the design and Turner Construction for the construction, Blair Freeman who's our project manager because we were all very concerned and intentional about this blending in. One of the designers used to say, if we do this right, the building will just sit softly on the property. And when he said that, I thought,
yes. So one of the biggest compliments we get is somebody drives by and they don't know what we do here. And when they ask around, it's usually, is there a new school over there? Now we've got Brandy and they can see the signs and they can see Charles Drew, but it fits. And we're next door to a church and it fits the property. And just to be clear based on our last conversation, we're not a locked facility, and we're not a correctional facility. Right.
And so as those conversations evolved as we were talking about the young people we're gonna serve, here come the assumptions and the stigmas of, oh, well, that means, no. We're actually going to do a different way. It'll be a treatment facility, be rehabilitative treatment facility. It is not locked. It's not detention. It's healing. So the neighbors have again, that was several years in the making that
they've they've embraced that idea. They're very proud that that is right here in this neighborhood. We talked a lot about community and it means that's an integral theme to this whole thing. It's all about community. Is there anything else you wanna wanna add as far as how communities is so integral to how Radius operates? Yeah. I would just add as we know, community is how you define it. So we've just talked about community being the local community, those that live
right here. And there's a wider net for the North Omaha community. Omaha on there is the community in general. And so we've had to do work in all of those spaces because you need all of the supports from the neighbors, from the citizens of this part town, and from the city of Omaha, which gives us great opportunities to educate because the average Omaha is not aware of what we're doing. It may not be in this neighborhood. And so that work continues.
It doesn't stop, but the ring keeps getting bigger so that we're educating and advocating to the entire community. I mentioned that's one of the things you do really well is advocating and growing that ring. What else does Radius do really well? And what do you think you're doing differently than your peers? And how can you act as a model in other communities really around the country? There's several unique things that we do well that I know are unique not only this community but the country.
The the family work that we do, what we call in home services, the fact that that starts the very day of admission evidence based program from Boystown. It's got research behind it. And the key is that we need that entire time to build a relationship with the family. Most residential programs, if a young person is gonna with the family.
Most residential programs, if a young person is gonna stay nine or twelve months, the first six to seven months, you really just focus on the youth that's living there. And then you start the family work. The needs of our youth and families are too complex. We have to start that right away. So we're very unique in that. The second thing is the partnership with Charles Drew Health Center on this campus.
I'm not aware of another one in the country with a treatment facility like ours with a freestanding federally qualified health center. And as a federally qualified health center, Charles Drew is not only a trusted health care partner, but they have expertise in social determinants of health and chronic health conditions of which every which every youth here and their families have.
We've integrated our programs while we are separate organizations, separately funded, separately licensed and accredited. But also, last week, we saw two of our former youth and their families coming back here for therapy, and they're coming back here for vaccinations. They left three months ago. And so the proof of concept of that continuity of care, which is so important in the research, we see happening. The third thing is this state of the art facility.
We've had interest in visits from people around the country and international interests. We've heard about the facility. What did you do from a design perspective? Right? The programs we're using, the evidence based practice, we did not create. Others are using those practices, but we put them together in a unique way in a facility that's built from that trauma informed lens. Open spaces, natural light, freedom of movement, as you know, highly safe, durable,
all of those things combined. What's happening nationally with populations like ours is the trend is really to keep them in a correctional based facility and then try to soften it up, bring in clinicians and bring in mental health and bring in evidence based practices, which is
a good step in the right direction. We've taken the opposite approach to say, we will design and build a non correctional facility, non detention facility with kids who literally come from detention and then implement all those programs, but the facility makes it work. If you haven't visited here, when you walk through our facility, there are large windows in every
single space. And when we built this facility and we're talking about the population we were gonna serve, many community members and professional colleagues said we love this place, but with all those windows, you have a budget to replace all because they're gonna get broken by the kinds of kids that you have. None have been broken. In eighteen months? In eighteen months.
And that relates to how we staff and how we program and the relationships and the environment doing what we believed it would do, which is support mental health and healing. Yes. And give space to handle very difficult behavioral situations. I have not seen another facility like this in the country, and we learn from others. So the team learn from different experiences and starts with being in facilities that but we don't want to look like that, and we shouldn't do
that. And let's take a little bit here and a little bit there. So I I think there's a lot of very unique things going on here we do well that that our family work will drive those long term outcomes. If we are successful, I believe it will rest on what we're doing to strengthen the families. Amazing to hear about the windows, and I'm sure there are other elements too that are really working well.
And I just love the comment about the windows because we all know the natural daylight is so important, and we know that creating a therapeutic environment actually helps reduce stress, which can reduce anxiety, which can reduce aggression and violence, and natural daylight and open spaces and softer materials help to reduce stress, right, which ultimately reduces negative incidents, right? It is happening. Amazing to
hear that it's working. One other feature, and it's within that design, but I wanna call it out a specific feature. We have a mindfulness room. We have a dedicated space in this facility, which, of course, has windows and natural light. And we have a mindfulness curriculum from an expert that we do with our youth and we do with our staff. Could be yoga, could be meditation, could be relaxation exercises. So that space that we design and is dedicated for that use and nothing else.
Else. Some wondered if we would get the young people raised to engage in those kind of progressive types of activities, and they love it. And it's part of all the things that we talked about, emotional regulation, learning skills taken the community. That space itself is very unique. I haven't seen many other facilities that have dedicated a space for that. So we're very proud of that. We think that's gonna really provide some good outcomes. Do you keep that space sort
of sacred to what it is? It is a meditation space, and we're not gonna go in there and use it for dining or use it for anything else. Correct. It is solely dedicated. So we've got sound for sound therapy, and we've got natural light. We've got artificial light. There's mats on the floor. You go there for one reason. It's for mindfulness and wellness classes. So it's pretty special. And, Nick, I heard there's a story about one of your residents that you'd shared. And do
you mind sharing that with the audience? Yeah. I I'd be glad to share it. And this is one of those moments where we know we're making progress. And so as I was out in the community area the other day, I had a young man approached me. He's very excited. First of all, he wanted to tell me that he had earned two high school credits, and he had a certificate, and he's working very hard to graduate high school. And as he said things like, I'm working on my diploma.
I'm gonna go home soon. I'm gonna get a job. And I said, what else do you need from us? How can we help you? And he said, my mom really needs help because my younger brother's at home and she is struggling. And she doesn't want them to have the same experience that I've had, so I need you to keep helping my mom because I've been away. And when I was home, I was almost like the other parent. So keep working with us. Help us. Help my younger brothers. Help my mom because she really
needs it. And so that's really powerful. One, that's the family work we're doing. Two, that really counters that stigma about our young people. Right? That they don't care. They don't have empathy. They're not concerned about others. He's probably more concerned about his younger brothers than he is about himself, and it's genuine
because I see them at family visits. And so, yeah, that's a powerful example of the innovative work that we're doing and also really changing the script for how our young men and families are perceived given the situation there. Is there anything else you wanna share with our listeners? Well, we would love to spread the word. So we'd invite all the listeners to go to our website at radiusomaha.org. Learn more about what we're doing. There's beautiful pictures there.
We also have a mission video on our YouTube channel. And, obviously, we invite anyone to provide support. We are five zero one c three, nonprofit. So you can also donate and support us on our website so we can continue this mission for many years to to come. Nick, thank you. The work you're doing is tremendous for this community and for many others that are going to be inspired by you and the work that you're doing. So truly, thank you for what you do and really are
making a big impact. Thanks, Brian. This is a great opportunity, and I just appreciate having a chance to talk to you. For more information on our Listen Mental Health Matters series, please visit hdrinc.com/listen. There, you'll find more on HDR's approach to behavioral and mental health design, meet our team, and see samples of our work. If you like what you heard, be sure to rate us or leave a comment on Apple Podcasts, Spotify, or wherever you get your podcasts.