Chapter Ten – Critiquing and Replicating







This Chapter discusses criticisms made in the Sixties about Neville and Fraser House and provides some responses. Neville’s processes for extending Fraser House into the local community are detailed. The Australian society’s processes and sanctions for placing boundaries upon behaviour and for accommodating diversity are detailed and these are contrasted with Fraser Houses and Neville’s use of therapeutic community to fulfil the same functions. Neville’s setting up of transitions to community self-caring is detailed, as well as Neville’s intentional actions contributing to the phasing out of Fraser House. Research on Fraser house evaluation is briefly outlined. The Chapter concludes with ethical issues in replicating Fraser House and some conclusions about the research questions.




As leader, two of the roles Neville used were ‘enabler’ and ‘orchestrator’ of self organizing action by others. For this, Neville was accused of being irresponsible and not doing his job of leading - loosely defined as, ‘telling everyone what to do’. Being the Director and Psychiatrist in charge of the Unit, he was expected to do just that. In his profound love of all involved, Neville said (Dec 1993, July 1998) he was accused of being, ‘too emotionally close’. In his tight, tough, humane, meticulously specific, and precise interventions in crisis contexts he was accused of being a megalomaniac. Accusations would depend on which moment a critic happened to be observing. The seeming conflicting roles of non-interventionist/interventionist and uninvolved passive/totally involved tyrannical megalomaniac are fully consistent with use of opposites and cleavered unities. Neville’s behaviour was consistent with his behaviour being appropriate to each passing moment and context.


There is another sense in which Neville used control and abandon in his own functioning. It is resonant with what Castaneda (1974) wrote about the Yaqui Indian, Don Juan’s way. Don Juan spoke of walking the path between control and abandon and how to combine both of these in peak performing - to control oneself and at the same time abandon oneself – to calculate everything strategically - that’s control, then once this is done, to act, to let go; that’s abandon.


Neville could seamlessly slip between control and abandon or use both simultaneously at differing levels of functioning. This letting go and abandoning is resonant with Wolff’s writings in his book, ‘Surrender and Catch’ (1976). Even in surrendering/abandoning there is keen sensing of what others may not sense.


The above accounts for seeming contradictions in Neville’s behaviour. As for the efficacy and appropriateness of Neville’s actual behaviours in context, that is outside the scope of this research.


Clark and Yeomans wrote that during the early months of Fraser House Neville exercised tight control in supporting his staff against the anxieties in the change-over from ‘old and trusted methods of managing patients to new and unfamiliar techniques’ (1969, p.41-42). They mention that this function was critical in the early days when situations occurred like patients being arrested at a local hotel, violent quarrels breaking out between patients, cases of window smashing, insubordination and outbreaks of panic. Clark and Yeomans go on to say ‘however, as confidence was created in the new methods, staff learned to meet and handle emergencies without the continual presence of the director. As staff felt more confident, patients became more secure and the frequency of emergencies decreased (1969, p.41-42).


The response to Fraser House ranged from recommendation to condemnation. In their book about Fraser House Clark and Yeomans report (1969, p.54):


Many professional workers, psychiatrists, psychiatric workers, psychiatric nurses and clinical psychologists, have expressed antagonism towards the practices of the Unit. They have claimed, among other things, that the confidences and the dignity of patients are not respected in the traditional way, and that the treatment is crude and administered by unskilled personnel. They describe instances in which relatives of a patient have been denied information about the progress of treatment, or had pressure exerted upon them to attend group therapy meetings against their own wishes.


At a more personal level, charges of flamboyance and irresponsibility have been made against the director of the unit (that is Dr. Neville Yeomans). Some practitioners have refused to refer patients to Fraser House because of their feelings of disquiet about its personnel and practices.




I will respond to the above criticisms; firstly, the report that ‘relatives/friends of a patient had pressure exerted upon them to attend group therapy meetings against their own wishes’. I have discussed that ‘family and friends attending Big Group’ was a condition for patient entry to the Unit. I have included a letter sent to friends and relatives encouraging them to attend (refer Appendix 11). That letter said that if requested, a group of patients could call on friends and relatives to explain things, and answer questions. In respect of the claim that pressure was being exerted against people’s wishes, Neville stated that this certainly occurred fairly regularly as particular circumstances arose.


Some families went out of their way to not cooperate with efforts to treat family members. Neville wrote:


Family inconsistency and conflict, distrust of the hospital, etc is most commonly and in fact almost solely found amongst the relatives of the most severely ill of all patients. It characteristically arises with the relatives of severely schizophrenic and major narcotic addicts, murderers, and violent patients; far more than in any other group which is perhaps a reflection of the extreme tension and distortion under which these families live, making them suspicious of any efforts to help them (Yeomans, N. 1965a, Vol. 5, p. 44-45).


Appendix 21 contains a relevant case involving a tangled inter-generational inter-family dysfunctional group of six where considerable pressure was put on a dysfunctional person not involved in Fraser House at the time though linked to a dysfunctional network. Readers can draw their own conclusions about the efficacy of the pressure to attend Fraser House in this case.


As for the claims that the treatment was crude and administered by unskilled personnel, the reports of those I interviewed was that patients and staff alike became extremely competent in a whole range of processes outside of conventional mental health practice. The Unit became the centre for teaching new psychiatrists ‘community psychiatry’. Fraser House patients played the major role in training these new psychiatrists.


In respect of the criticism that confidences and the dignity of patients were not respected in the traditional way, we have discussed the often tough and provocative nature of Fraser House community process. Neville described his way as being ruthlessly compassionate in intervening, interrupting and sabotaging people who were adept at maintaining and sustaining their own and/or others’ dysfunction.


In Fraser House people changed where nothing else had worked in the other places they had been.  Relatives and friends of a patient were often denied information about the progress of treatment. It was regularly found that many relatives and friends were very prepared to use information about a patient’s progress to destructively sabotage that process.


It is to be expected that what Neville was doing would create ‘peer disquiet’ about Fraser House personnel and practices. Anything that turns a profession on its head and strips away virtually every aspect of members of that profession’s traditional power and authority as both individuals and as a profession would create vehement opposition.


Each of my Fraser House interviewees agreed that many newcomers to Big Group would have had the following experience (Clark and Yeomans 1969, p. 54):


Some patients and their relatives and friends have shown extreme fear of, and hostility towards, the practices of the Unit. They describe vividly their feelings of horror and helplessness when first exposed to the interrogation or verbal attack of a group of grossly disturbed people. Frantically, they look towards the staff for protection, but support is not forthcoming. The inescapable conclusion is reached: staff and patients are united in their efforts to uncover innermost secrets and to probe sensitive emotional areas without remorse.


Every Fraser House interviewee said that Big Group was an extremely intense experience and in all of this, there was profound framing compassion and a relentless drive for all involved to be moving to being able to live well in the wider community. As for being flamboyant, Neville was a chameleon who constantly changed to fit context. In keeping Fraser House before the public of Sydney, Neville was very prepared to be a flamboyant celebrity. Later, when he was quietly evolving networks among Indigenous people and wanting to minimize interference from dominant elements, he went out of his way to be invisible.




Dr. N. M. Mitchell from Kenmore Psychiatric Hospital in Goulburn was interested in setting up a 300 patient therapeutic community (based on Fraser House) within Kenmore, a psychiatric hospital with over 1,800 patients (Mitchell 1964). A file note by an unnamed author in Neville’s collected papers states:


Dr. Mitchell was sent to Fraser House for a week of intensive training and received copies of Fraser House’s rules, administration structure and committee organization. Neville had visits to Kenmore and visited Goulburn Base Hospital and developed liaison between Goulburn Base Hospital and Kenmore. Neville engaged in four days of continual supervision at Kenmore during one phase when he ran small and large groups in every ward of the hospital and delivered talks to all members of both staff and patients throughout the entire hospital’ (over 1800 people). He also supplied Kenmore with a research instrument to act as case history records.


While their therapeutic community had around 300 patients Neville ensured all involved in Kenmore and the local hospital knew about this new Unit (Yeomans, N. 1965a, Vol. 12, p. 66-69).


Note the thoroughness of Neville in ensuring every single patient and staff member, as well as the local base hospital, were all thoroughly briefed on the new therapeutic community unit at Kenmore.


Neville’s work with Dr. N. Mitchell and Dr. J. Russell at Kenmore was featured in a newspaper article on 19 June 1963 called, ‘Kenmore’s Group Therapy Plan – Leading Psychiatrist Visits Kenmore’ (Evening Post 1963) (Photo 29 below). Dr. Mitchell is quoted in the article as saying, ‘A large-scale community living or group therapy used at Kenmore since late last year has proved an unparalleled success’. Kenmore modelled their Committee structure/process on the one then in use within Fraser House (Mitchell 1964). I interviewed Dr J Russell as well as her son Ian who had lived on the Kenmore Hospital grounds with his mother (Feb 2002) who both confirmed the above.




This segment looks at Neville’s contextual frames for positioning Fraser House praxis in fostering a transition to a humane caring epoch. Neville spoke (July-Aug, 1998) of Western society having four levels of functioning relating to regulating of conduct - namely, values, norm, rules, and obligations.




Photo 1 Newspaper Clipping Neville placed in archive ‘Dr. Yeomans at Kenmore – Goulburn’ Evening Post, 19 June 1963. (segment missing)


Figure 1 below shows Neville’s framework that he outlined to me (Dec 1993) based on these four levels. It also shows the normal and deviant behaviours associated with each of the four, and also the typical societal ‘correcting’ agencies associated with each level. The criminally insane are typically deviant on all four levels. Criminal people and the socially dysfunctional may deviate at any level. Australian society’s correcting agencies provide a ‘service’ role for the community at large. In large part, level two and three service is provided by some level of government - the public sector. Some private sector contracting-out occurs; for example, private prisons. Private commercial practitioners (service providers) may be supported by government funding arrangements; for example psychiatrists and physicians in level four. Voluntary service providers also assist; for example, church based social and counselling services and youth-outreach services in level one and aspects of level four. Outside the massive service provider arrangements is now an extensive network of self-help groups.


Self-help blossomed in Australia in the Seventies and Eighties in large part because of the enabling impetus of Neville in the Sixties and early Seventies, discussed in Chapter 11.


The social-pathology support framework of Fraser House and the Laceweb assumes that resident behaviour is a function of pathological social networks - a failure at the community level, and also assumes it is in part a function of pathology within the wider society. While Fraser House was a service provided by the NSW Health Department, life within Fraser House was pervasively self help.


Within Fraser House there was no service based correcting agent - where ‘agent’ means someone who does something for you – rather, within Fraser House the correcting, remedial and generative processes operating at all of the four levels of functioning depicted above in Figure 1 becomes the therapeutic community, which by its nature, is bracketed off, though embedded in local community.
















1 Values











Moral leaders


Therapeutic Community



2 Norms















Therapeutic Community



3 Rules










Therapeutic Community



4 Obligations



a) Role




b) Task






Role responsibility








Mental Illness



Physical Illness
















Therapeutic Community



Therapeutic Community



Figure 1 Maintaining Conduct and the Correcting Processes


In Neville’s framework, the notion of ‘service delivery’ by ‘expert’ ‘corrective agencies’ is replaced by self-help, and mutual or community help by the therapeutic community. This is resonant with Indigenous community sociomedicine for social cohesion. The therapeutic community is supported by nurturing enablers as ‘resource people’. The paper ‘Government and the Facilitating of Grassroots Wellbeing Action’ (Yeomans, Widders et al. 1993a; Yeomans, Widders et al. 1993b) suggests ways that self-help, and mutual or community Grassroots wellbeing action may complement top-down service delivery.


In Fraser House, residents explored, clarified, and developed their values and reciprocal obligations together. They developed their own community lore, law, rules, norms and obligations. They were living within Fraser House’s more functional value, rule, and norm systems that they were evolving and continually reviewing together as a caring community. This co-reconstituting of the rules and norms they lived by was embedded within every aspect of communal life in Fraser House. The values, lore, law, rules and norms embodied humane caring self-help and mutual-help. These aspects were never reified – as if they were immutable and coming from God. As Kuhn pointed out in his writings about the potency of paradigms (1962; 1996), the processes constituting and sustaining societal paradigms are reified and rarely if ever noticed or questioned. Neville created a context where the social constituting of the Fraser House shared reality was made explicit and kept under continual review by the Fraser House community. Goffman had written about various types of total institutions. Neville fitted these total institutions into the above framework of values, norms, rules, and obligations as depicted in Figure 2. (‘Comparison of Goffman’s, ‘Total Institutions’ and Fraser House’ is Appendix 2)


Neville described Fraser House as a ‘transitional community’ as it was continually adapting to meet changing contexts and challenges. There was a culture of continual improvement in being well – wellbeing. Neville described all this as ‘micro-processes’ that may be used in returning a way of being and living together to wider society in Australia – a culture that Neville described (Dec 1993) as been subject to the cultural stripping by the Rum Corps at the very start of European settlement in Australian - where in Neville’s terms,’ Irish and other settlers and local Aborigines alike all had their culture stripped systematically from them and a military culture imposed’.















1 Values



Capable and in retreat


Abbeys, Monasteries, Convents



Moral leaders



2 Norms




Capable and deliberate threat to society



Jails, Penitentiaries, POW Camps,








3 Rules




Capable and there for instrumental purpose


Army Barracks, Ships






4 Obligations



a) Role



b) Task






Incapable and unintended threat to society


Incapable and harmless






TB Sanatorium,

Mental Hospital


Blind, Orphaned, Aged, Indigent





Physician, Psychiatrist


Physician, Carer


Figure 2 Neville’s Four Levels and Total Institutions


Neville embedded the framework depicted in the above table into the evolving Laceweb. The distinction between mainstream ‘service delivery’ approaches and the self-help Laceweb model is discussed in Chapters Twelve and Thirteen.


Figure 3 below is Neville’s extension of Figure 1 and depicts the way society accommodates diversity between people, socio-economic groups, ethnic groups and cultures. Societies have varying degrees to which they will allow protest and dissent. The columns are lists (rather than a table) of correcting processes for resolving deviancy from within or from outside the society. The right-hand column gives the Fraser House/Laceweb healing processes for healing deviancy in all its forms towards having cleavered unities that respect and celebrate diversity.




Fraser House offered primary patient care by skilled psychiatric nurses to many surrounding organizations. A Fraser House social worker was based in the Hunters Hill Council Chamber’s Administrative Office providing a service to the public half a day a week. Neville was continually giving talks to church groups and other organizations about Fraser House and its processes. Neville set up what was called the Sydney Therapeutic Club on the veranda of Ward One at Sydney Hospital (Yeomans, N. 1965a, Vol. 5, p. 104). Neville worked closely with eight social workers at Sydney Hospital. Some of the social workers were trained in group therapy and the Consultative Mental Health Programme was established. Six of the social workers attended Fraser House groups. Sociotherapy groups were held regularly at Sydney Hospital for three years (Yeomans, N. 1965a, Vol. 12, p. 70). Fraser House patients and ex-patients attended these Sydney Hospital Groups. Neville announced the start of these Sydney Hospital sociotherapy group meetings during a Fraser House Big Group that was very tense, as a catalyst for change in that Big Group’s mood.












Fraser House/








Current way:

























Possible way: Harmonious














Venting energy




Coercion &



Warrior system

 - yang







Torture &


Shaming &



(Towards status quo in current way)



Cultural Keyline

Healing nurturing –  Yin

Therapeutic Community

Mediation Therapy


Healing/Wellbeing networks

Festive, and celebratory gatherings

Everyday life wellbeing processes








(Towards possible way of harmonious cleavered unity)



Figure 3 Neville’s Figure Depicting the Way Society and Fraser House/Laceweb Accommodate Diversity Among People, Socio-Economic Groups, Ethnic Groups and Cultures


As an example of linking Fraser House to the wider community and vice versa, during 1965, assistance was given on an individual or workshop basis by members of the Fraser House Research Group to thirteen organizations listed in Appendix 22 (Yeomans, N. 1965a, Vol. 12, p. 94). Seventeen people from the Parramatta Psychiatric Centre met monthly under Neville’s chairmanship on eight occasions (Yeomans, N. 1965a, Vol. 12, p. 85). Members of the Salvation Army undertook training in group leadership at Fraser House. Brief and extended training courses also included clergymen from all Christian denominations. Also involved were family welfare agency counsellors, parole officers, and nurses and administrators from private hospitals. Neville also advised the Salvation Army on the development of hostels (Yeomans, N. 1965a, Vol. 12, p. 72). Neville was the Honorary Consulting Psychiatrist at Langton Clinic for Alcoholics. He also guided that hospital on therapy, policy and research (Yeomans, N. 1965h, Vol. 12, p.70).


In the above action Neville was providing support to each of the mainstream institutions outlined in Figures 1, 2 and 3 who were providing mainstream service delivery based correcting processes for people deviating from society’s values, norms, rules and obligations. Neville also linked with senior people in the criminal justice prison system through the Fraser House Psychiatric Research Study Group. This linking is another example of how Neville explored interfacing his ways with mainstream ways.

                                                                                                                                                                                                                                                       Neville also gave many talks and interviews about Fraser House that were broadcast on TV and radio. This was confirmed by Neville, Chilmaid, and Bruen (April 1998). Neville was the Guest of Honour at the All Nations Club on 30 August 1963 (All Nations Club 1963). A draft of a speech on social problems to the Ionian Club Sydney entitled, ‘Introduction on the Origins of the Ionians’ is included in Neville’s archived papers (Yeomans 1968a). On one occasion a TV crew from the ABC came and filmed a section of Big Group. One of the intentions of these interviews was to have the public know so much about what was happening at Fraser House, that it would raise a hue and cry if there were any moves to close the Unit.


One of the things Neville was exploring when he was away overseas for nine months in 1963 was the state of the art in community based healing approaches in the United States and the United Kingdom. In Neville’s view (Dec, 1993; July, 1998) Afro-American community child care centres and community welfare centres in the USA were state of the art (Yeomans, N. 1965a, Vol. 1, p. 70-80); they were looking after their own. Neville conveyed this in a letter to a Fraser House colleague (1965a, Vol. 1, p. 70-80).


Upon his return Neville wrote a report (1965a, Vol. 1, p. 70-80) recommending that community mental health centres be attached to schools, because school counsellors meet the families. Neville’s report recommendations were shelved. Neville energized the Paddington Children’s’ Community Centre based in part on the Afro-American New Haven Community School he visited in America (1965a, Vol. 1, p. 70-80). This linking of support to schools has some resonance with what happened in the NSW town of Bourke as a result of two Aboriginal members of that Community attending a Human Relations Gathering enabled by Neville in Armidale, NSW in 1971. This is discussed in Chapter Eleven.




Fraser House was the first mental institution in Australia to identify surrounding suburbs as an area of ‘special interest’. Church and other community groups in the area were approached and told about the programs and processes used at Fraser House. Neville was a frequent speaker at these groups. People from the groups were invited to attend Fraser House as guests at Big and Small Groups. Fraser House research people gathered data relating to the mental health in the surrounding area. This area came to be known as Fraser House’s ‘catchment area’ (Yeomans, N. 1965a, Vol. 4, p. 2-4).  Neville had supported the setting up by Dr Mitchell of a therapeutic community in Kenmore Hospital in Goulburn, and Kenmore was one of the first hospitals to follow Fraser House in using catchment areas (Mitchell 1964). This notion of catchment areas has spread through mental health services. This was an innovation that contributed to the demise of Fraser House as a total and voluntary therapeutic community. In 1968, the areas around Lane Cove were designated the ‘Admissions Catchment Area’ for Fraser House, and from then on involuntary patients (people being committed) were admitted to Fraser House. This fundamentally distorted and collapsed the Fraser House voluntary self-help process.




Neville delivered a paper at the Pan Pacific Rehabilitation Conference in 1968 called ‘The Therapeutic Community in Rehabilitation of Drug Dependence’ wherein he wrote about steps he was taking towards evolving community mental health.


Since September 1965, Fraser House has been innovating a community psychiatry service for approximately 300,000 population. This programme aims at intense contact with government public servants, community aid services and all other relevant community leaders including police, ministers of religion and all those depended upon by large groups (Yeomans, N. 1965a, Vol. 1, p. 267-289).


In a document marked ‘confidential’ called, ‘A Community Developers Thoughts on the Fraser house Crisis’ (1965a, Vol. 2, p. 46-48), Neville writes of actions that would lead to the phasing out of Fraser House.


Over the last couple of years the Unit Director and developer (Dr. Yeomans) has been increasingly involved in strengthening the organizational preparedness of the outside community, aimed at the relative devolution of Fraser House and the development of an external therapeutic (welfare) community.


Neville does not expressly state what the ‘crisis’ was that was implied in the title of the article. In terms of attack from psychiatrists and other health professionals opposed to Fraser House process, the Unit had been ‘in crisis’ from inception.


A shift to a ‘community mental health’ focus and a further widening of focus to embrace ‘community health’ via ‘strengthening the organizational preparedness of the outside community’ was hinted at in the forward to the second edition of ‘Introducing a Therapeutic Community for New Members’ (Yeomans, N. 1965a, Vol. 4).


The major changes in the programs of the Fraser House Therapeutic Community in the past 20 months (1965/1966) have been the development of an intense Community Psychiatry Programme, first in Lane Cove municipality in September 1965, and more recently in the Ryde Municipality. The major Therapeutic function of Fraser House will now be as the centre for an intense Regionalized Community Psychiatric Programme. This programme is aimed at reducing the rates of mental and social illness in this part of Sydney as a pilot programme and involves a vast increase in the outward orientation and responsibility of the Unit. Groups of nurses were allocated localities in the suburbs surrounding Fraser House and supported patients and outpatients from their areas.


The Fraser House handbook for new staff has a segment on the Nurses Role:


Nurses are assigned in teams to regional areas at the moment; Lane Cove, Ryde, the rest of North Shore, and other areas. Each regional team is expected to be responsible for knowing its area, its problems and helping agencies etc. Moreover, nurses in each team are expected to come to know all in-patients and out-patients of that area; to be specially involved in the appropriate regional small groups, both in the community and in the Unit; to record progress notes on their regional patients; to be part of both medical officer and follow-up committee planning for the patients of their region (Yeomans, N. 1965a, Vol. 2, p. 18).


In September 1965 the Lane Cove Community Psychiatry Programme began. In June 1966 a similar programme began in Ryde (Yeomans, N. 1965a, Vol. 4, p. 2-4).


In discussion with Neville (Nov 1998) about Figures 1 and 3 above he said that while Fraser House had been a seminal step, it was still a State run enclave. Kenmore Therapeutic Community was another State run enclave. Ex-staff member Dr. Madew was replicating Fraser House at Callan Park where the therapeutic community was called Bayview House.


Neville wanted his ideas spreading outside of State control. His next step was to move Fraser House way out into the community and slowly move community-centred action away from service delivery and towards grassroots self-help and mutual-help. Neville spoke (Dec, 1998) of this as, ‘returning wellbeing processes back to grassroots folk’.


In 1993, Neville engaged me in writing with him and Terry Widders about the gulf that exists between Grassroots self-help and Government (1993a; 1993b). In that paper Neville describes the fulfilment of his aspirations in the Sixties when he was shutting down Fraser House as a Government Institution embedded within an expert service delivery tradition.

Across Northern Australia influences are being generated that are placing the impetus for nurturing cultural action for wellbeing back at the place it breaks down - with local people as they go about their lives. It is a lateral and bottom-up action. Small groups engage in action and keep using practices that work for them. Others become involved and initiatives, starting 'at the bottom', work their way 'out' and 'up' to include more of the wider community.

To have Fraser House process start to move out into civil society and then into grassroots self-help networks Neville sensed it was best to let Fraser House be re-absorbed by mainstream and disappear. He did not want Fraser House remaining as a government administered service delivery entity that was a mere shadow of how it was when he was there, and for this ‘atrophied anomaly’ to be presented as ‘Dr. Neville Yeomans’ Therapeutic Community’.



Neville told me (Dec 1993, June-July 1998) that he had predicted in the 1960’s that therapeutic communities in psychiatric hospitals in Australia would cease to be. Neville had predicted the locus of power shifting within state controlled psychiatry from patient self-help and self-governance back to ‘power-over the disempowered patient by professional experts’. Neville also predicted the reasons for this. They were identical to David Clark’s description of the causes of the closure of Therapeutic Communities in the UK Hospital systems outlined in Chapter Three. Neville’s predictions proved correct. I have not been able to find a hospital-based therapeutic community left in Australia. Therapeutic Communities do operate as smaller typically non-government bodies and are more active in supporting people with drug related issues.

Neville said (Dec 1993, July 1998) that within Fraser House, psychiatrists experienced their maximum career disempowerment. Neville held the forces that wanted to annihilate all trace of Fraser House at bay for nine years.

Neville had intentionally positioned Fraser House in the ‘declining old cultural system at the margins’ to research both the internal and external process of setting up an organisation deemed ‘radical’ and ‘anarchic’ by the old cultural synthesis.

Neville in 1967 and 1968 arranged for opponents of Fraser to get their way after he had achieved everything he wanted at Fraser House. He then wanted to move the Units processes into civil society in Sydney and then into remote areas away from external interface with the power centres of Australia – especially Canberra and the State capital cities.



A cost-benefit analysis designed by Neville revealed the Unit to be the cheapest and most effective compared to a traditional and to a very new ‘eclectic’ unit (Yeomans 1980a; Yeomans 1980b).


Chilmaid (Sept 2004) said:


Fraser House costs matched the two admission units but had many more outpatient numbers, both attendees & assertive outreach (follow-up visits) and groups, so cost per patient day must have been lower; due to length of stay, patient throughput was also lower.


Treatment results were followed for up to five years and this research showed that improvement results were maintained (Clark and Yeomans 1969).


Madew, Singer & MacIndoe (1966) conducted controlled research in Sydney at Bayview House Therapeutic Community[1] within Callan House. They found that the therapeutic community was significantly better at returning patients to the community. The therapeutic community costs were also significantly lower than the control group.


In 1993, Alfred Clark published his book, ‘Understanding and Managing Social Conflict’. In this book Clark specified the 1959-66 ‘Fraser House’ model as being still ‘state of the art’ as a process for intervening and resolving social conflict within any context around the Globe (1993).




Neville was delighted to discover that Fraser House was one of the models used in comparative research by Paul and Lentz in their 1968 research based in Illinois, USA (1977, p. 432). Paul and Lentz used Fraser House as one of their models in developing their milieu therapy program. However, many of the unique features of Fraser House were not used by the American researchers. The researchers had also used a ‘poor cousin’ of Fraser House model in their social-learning program as well. The American researchers used a token economy. Neville set up a small actual economy within Fraser House (for example, the canteen, the bowling green and packing light globes).


The American research strongly supported the efficacy of the Fraser House model. Over the four and a half years of the American research and the next 18 months follow-up, the psychosocial change programs were significantly ahead of the hospital group on all measures, with social learning emerging as the treatment of choice.


While Paul and Lentz’s clients had been chronic mental patients who had had long-term hospitalisation, with the social-learning group fewer than 3% failed in achieving ‘significant release’, defined as being longer than 90 days in outside extended-care facilities. 10.7% of the original social-learning group and 7.1% of the milieu group were released to independent functioning, without re-institutionalisation. None of the original hospital group had been released to independent functioning.


A cross comparison between structures, processes, actions and underlying theory within Fraser House and Paul and Lentz’s psychosocial programs shows that Fraser House contained the aspects that constituted the effectiveness of both their milieu and social learning programs. Some of the features of the American models were present within Fraser House in a more advanced form. Fraser House also had a large number of features that were not present or referred to by the American researchers.  To demonstrate the ‘total’ nature of Fraser House, the Unit’s features that were neither present in the Paul and Lentz’s American research (1977) nor referred to by the American researchers are listed in Appendix 23. Consistent with opposition to Fraser House, Paul and Lentz’s treatment unit was closed by authorities shortly after they published, notwithstanding their excellent results.




It is possible that psychosocial change may be implemented in incompetent, inappropriate and unethical ways. Attempts to set up psychosocial change programs may go seriously astray to the point where people may be harmed or killed. We have seen that the Fraser House therapeutic community psychosocial programs were, at various levels, both simple and complex in their structure and processes. Both highly specific and very non-specific change actions were used. Many of the structures and processes were not obvious. Many were very subtle. Incompetent people with the best intentions in the world may seek to establish psychosocial change programs. They may operate under a belief in the ‘magical’ quality of the approaches used - that you set a unit up and ‘let the magic happen’.


The consistent feedback from all my Fraser House interviewees was that Fraser House was a ‘massive amount of very tight and difficult work’. As mentioned, in Fraser House detailed attention was focused on being extremely flexible within extremely tight psychosocially ecological boundaries. One of these frames was safety at all levels - physical, emotional, psychosocial, ethical, moral and spiritual. Meticulous and constant attention was also focused on staff teamwork with team building, team-maintenance and teamwork under continual review. The staff were so dedicated and committed to each other and the community, Neville had to constantly insist that they go home after their shifts ended instead of staying on to do things to support. Recall that the groundwork laid down by Neville allowed him to be away overseas for nine months in 1993 with Fraser House thriving in his absence.


Neville was adamant that for any cloning of Fraser House to be ecological, it would have to grow naturally and be context and local place dependent; this included how it was embedded within the local suburbs to ensure the natural evolving of strong functional local patient networks. An important issue in replicating Fraser House was that Neville was a very skilled and very charismatic person and there are few ‘Neville’s around (given his Keyline and Indigenous precursors). As an example of his total completeness Neville spoke to all 1800 (plus) staff and patients at Kenmore in setting up their therapeutic community. As well, as detailed in this thesis, many of Neville’s ways were not obvious.


Dr. Mitchell’s Kenmore Therapeutic Community and Dr. Madew’s Callan Park were successful examples of cloning Fraser House. Dr. Madew was on staff at Fraser House prior to heading up Callan Park. As mentioned, Neville worked closely with Dr. Mitchell in setting up Kenmore Therapeutic Community.


One attempt at setting up a therapeutic community was the Ward 10B unit set up by Dr. John Lindsay at the Townsville General Hospital Psychiatric Unit (1992). Some years before, Dr. Lindsay had requested permission to be, and had been an observer at Fraser House for three weeks. Neville told me in 1992 in Yungaburra that Lindsay believed that he ‘slavishly’ copied aspects of Fraser House in establishing and running Ward 10B. In doing this, Neville said that, ‘Lindsay did not allow for the structure of the city of Townsville’. Neville said that in Ward 10B there was ‘no evidence of locality or evolving a way of life together connected to place’ (localised networking) - what Kutena (2002) called ‘cultural locality’.


Neville told me (Dec 1993) that after Neville visited Ward 10B he completely dissociated himself from having anything to do with it. Neville said (Dec 1993) that this was because he sensed that Dr. Lindsay had ‘too faithfully followed Fraser House in a different State, political and metropolitan context’. As well, there was evidence that the Ward 10B staff were far from being an effective team. Ward 10B was in no way encapsulating the Fraser House processes.


(In contast, Fraser House staff rapport process was described in the following terms:


The emotional comfort and satisfaction of the Unit staff is one of the most significant features of the (Fraser House) therapeutic program. The numerous staff meetings aim to foster this. Specifically their role is to prevent the development of covert, hidden conflict between staff members about patients. Such conflicts are proven to result in overt patient disturbance. The staff remains the most powerful members of a therapeutic community and their welfare and comfort are of paramount importance (Yeomans, N. 1965a, Vol. 4, 50-54).


Following many complaints, Ward 10B was closed and became the subject of a Commission of Inquiry that reported in 1991. This inquiry sought to find out if negligent, unsafe, unethical or unlawful acts had taken place. The conclusions of the report (Queensland Commission of Inquiry 1991, p. 461) were in part:


Clause 20.4 The primary lesson to be learned from the findings of the Commission of Inquiry is that what happened in Ward 10B between March 1975 and May 1987 must never be allowed to be repeated in this or any other psychiatric unit in any hospital in the State.


Clause 20.5 The mentally ill population deserves expert care, compassion and solicitude, not abuse and rude confrontation, and above all they deserve to be spared from the excess of those who would wish to impose upon them eccentric and idiosyncratic treatment philosophies. Even more so, they deserve to be treated with all of the skill and learning which the caring professions can offer them.


Dr. Lindsay gave his version of events at the Townsville Unit in his book, Ward 10B - The Deadly Witch-Hunt (1992).


I sense that Ward 10B can stand as a warning to anyone who may want to implement ideas culled from this thesis without allowing for the interwoven richness of Neville’s way and value underpinnings.


It would be useful research to compare differences between Fraser House and Ward Ten, especially between:


·         the roles of the respective directors

·         the respective director’s relationship with the respective staffs, and

·         the respective treatment philosophies




Neville’s poem ‘INMA’ (included at the start of this thesis) is about social networking in Far North Queensland and the Darwin Top End in what Neville Termed an INMA or Intercultural Normative Model Area. As I stated in Chapter Two, it was some time before I started to see the fractal quality in everything Neville was doing and how all the diverse bits were parts of the whole. It was not until May 2004 that I suddenly realized that Fraser House process was isomorphic with the INMA poem.


Extracts from the poem:

It believes in the coming-together, the inflow of alternative human energy, from all over the world (2000a).

Neville first created the coming-together of ‘alternative energy’ – people he termed ‘the mad and bad of Sydney’ (Dec, 1993).

It believes in an ingathering and a nexus of human persons’ values, feelings, ideas and actions (2000a).

As for an ‘ingathering and an nexus’, Neville first created the ingathering into Fraser House from the NSW psychiatric hospital back wards and prisons. The Fraser House community created the nexus and it was a nexus of ‘human persons’ values, feelings, ideas and actions. This links with Neville having the staff meetings to review themes, mood, values and interaction during big and small groups.

Inma believes in the creativity of this gathering together and this connexion of persons and values (2000a).

The Fraser House ethos and experience was that the creativity and wisdom was in the community coming together and consequent nexus of persons and values.

It believes that these values are spiritual,
moral and ethical, as well as humane, beautiful, loving and happy (2000a).

The Fraser House evolved value system shared all of the above values.

Inma believes that persons may come and go as they wish, but also it believes that the values will stay and fertilize its area, and it believes the nexus will cover the globe (2000a).

Fraser House patients could come and go as they wish and the values of Fraser House did stay and were spread into the wider Sydney area and beyond.




Bloom (1997) quotes Abroms who describes milieu therapy (community therapy) as a ‘treatment context rather than a specific technique…a metatherapy.’ Neville’s process created a very special context whereby every aspect of social interaction was re-constituting people. Neville demonstrated that dysfunctional people can provide mutual help in evolving a reconstituting, self-governing, functional, transitional community that could continually take in dysfunctional people and their networks, and constantly generate and disperse them within a three month or less time frame as ‘‘functional family-friendship seeding networks’ into wider society.


Patients typically finally left Fraser House with a network of around seventy people. Upon leaving, these networks would be made up of current and former patients and outpatients. Within a few weeks of leaving, network members would be primarily ex-attendees of Fraser House. Upon first leaving, patients could return and stay as patients three times with the members of their growing family friendship network. These return visits were opportunities to increase functionality and importantly, to strengthen the experience base within their networks. As some of these returning outpatients may be members of a number of Fraser House connected networks - with members in, or returning to Fraser House - ongoing links back to Fraser House could be sustained for some time. Most of these networks were integrated networks (discussed in Chapter Thirteen), with nodal people as links to other integrated or network fragments and dispersed networks (also discussed in Chapter Thirteen). Nodal people would have links into other Fraser House integrated and dispersed networks. Within these networks were subsets of people who were closely known and regularly connecting. Others were linked with less frequently, though available as resource and support people. This all has implications. One is that after Fraser House had a number of months of regular outpatient attendances, Fraser House Big Groups began to be comprised of a substantial and influential number of ‘seeding’ patients among those about to leave, along with visiting outpatient members of their expanding functional network. These people all had experience in working at the edge in Big Group, as well as experience in training new psychiatrists in community psychiatry, engaging in Domiciliary care and Committee work, and being a member of a functional network supporting self and others. Having this core of people in Big Group (and disbursed through small groups) supported by Neville and the other staff, increased the capability of the whole group as crowd and audience to hold interest and stay at threshold. There was critical catalytic mass.


During the early to mid Sixties Fraser House was continually evolving functional networks of up to seventy people and having them separate off from Fraser House into wider society - somewhat like meiosis in human cells splitting to multiply. Wider society would have little knowledge of this seeding process for community change. Neville, staff and patients in domiciliary care roles remained potential and actual nodal persons into these networks.


After Neville and Margaret left Fraser House they both re-linked with some of the members of these networks in the late sixties and seventies. Neville and Margaret worked with ex-Fraser House patients and outpatients on community health initiatives when they found these people active in community innovation, change and enrichment, discussed in the next chapter.


The next segment explores the role of ex Fraser House patients in energizing local self help action.




Neville said (Aug 1998) that patients would typically leave Fraser House with a large family friendship network, as well as experience in helping administer a substantial organization. They would also have experienced the practical application of psychosocial research and have competencies in community therapy process.


It was little wonder that shortly after leaving Fraser House in 1968, Margaret Cockett was finding ex-patients around Sydney engaged in local self-help action. Typically, she found that ex-patients were very effective in group process and action as they had had excellent experience and grounding during their Fraser House stay. When the going got turgid and emotions heated up in these action meetings it was nothing that these ex-Fraser House residents and outpatients had not already experienced in Fraser House.


Margaret recalled one Fraser House ex-patient as been a very angry person at Fraser House. When this person was leaving Fraser House, Margaret thought that he had a ‘long way to go’ in being ‘functional’. She met and talked to him at a social action meeting. Margaret told him that she was surprised to find him there and said she thought he would be ‘railing against the government’ rather than being involved in this self-help action. Margaret said he replied words to the effect, ‘You have it all wrong. Change is happening at the everyday life level. It is useless trying to change the Government and the large power processes.’ This response was in fact resonating fully with Margaret and Neville’s view and draws attention to the profound difference between service delivery by experts (who do things for people) and self-help/mutual-help in modulating social relations. Neville wrote about this difference and how his way may be interfaced with mainstream way (Yeomans, N. 1971c; Yeomans, Widders et al. 1993a; Yeomans and Spencer 1999).




Elshtain asked the question (1995, p.91):


If one cherishes and champions individuality and community, diversity and commonalities, what resources are available in our contemporary civic repertoire that push in this complex direction?


Neville was evolving psychosocial resources cherishing and championing individuality and community, diversity and commonalities in the NSW civic repertoire.


I have been exploring the research questions, ‘What change processes, innovations and social action evolved in and from Fraser House? How do these differ from other psychiatric therapeutic communities? What were the outcomes and effects?


The above four chapters have document how Fraser House entailed structures and processes that far exceeded other therapeutic communities outlined in Chapter Three, hence Margaret Mead’s ‘total’ descriptor. Neville introduced behaviour to community psychiatry that involved:


·         thinking and acting as a personal eco-system

·         being a conscious extension of the eco-social system we are imbedded in

·         engaging in interacting with wider eco-social systems


Neville evolved processes for being a social catalyst for self-organising personal, family and community transition. He evolved the following as Fraser House change structures and processes:


·         Cultural Keyline

·         Total therapeutic community

·         Comprehensive community governance

·         Full family networking

·         Family-friendship networking

·         Intergenerational networking

·         Local and phone-based crisis and suicide support

·         Domiciliary care

·         Catchment areas

·         Big Group crowd and audience processes

·         Social category based small groups

·         Work as therapy

·         Psychosocial research as therapy

·         Values and moral vocabulary and dialogue

·         Values guided everyday life interacting

·         The weaving together of all of the above


Neville evolved a substantial body of biopsychosocial praxis that may be used by both professionals in service delivery and lay people in self-help in everyday life. The praxis also includes processes for useful interfacing between professional and lay people in supporting people towards increasing wellbeing. As such, Neville’s work is fundamental for the likes of Workcover in Victoria seeking a return to a biopsychosocial paradigm in professional care.




Neville suggested (Dec 1993, July 1998) that Fraser House became a powerful influence in closing mental asylums within Australia. He also suggested that Fraser House and Community Mental Health (which Neville pioneered) played a large part in no asylums been built in Australia since he left Fraser House.




This chapter commenced with criticisms made of Fraser House in the Sixties and some responses to these. Replicating Fraser House in Kenmore and Callan Park Hospitals was discussed. Material was provided contrasting the difference between Fraser House and wider society in containing behaviour. The steps taken by Neville to set up transitions to community self-caring was set out as well as Neville’s actions contributing to the phasing out Fraser House. Research on Fraser house evaluation was briefly outlined along with a discussion of American research using Fraser house as a model. Ethical issues in replicating Fraser House were also discussed. The chapter concluded with comments about the relation of INMA and Fraser House, a summary of my findings and the implications of Fraser House networking.


This concludes the set of chapters on Fraser House. The following chapter documents the various outreaches from Fraser House that Neville set up and enabled, and discusses how these fit into Neville’s frameworks for evolving a social movement fostering humane epochal transition.


[1] Bayview House was modelled on Fraser House.