The Micronesian Suicide Epidemic

by Brandon Chavez, January 25, 2021

Brandon Chavez is a freshman majoring in History. He enjoys learning about social and political issues in other countries & places around the world. He also enjoys learning about the challenges faced by indigenous populations.

***FALL 2020 CONTEST SUBMISSION***

”Suicide rates since 1960 in Micronesia (the U.S. Trust Territory of the Pacific Islands) have undergone an epidemic-like increase. This phenomenon is focussed narrowly within the 15-24-year male age-group”

(Rubinstein, 1983).

Family plays a quite significant role in Micronesian society. An individual’s self-esteem is very dependent on the acceptance and support of the family, more so than any other contributing factor. A firm place and role in the family is a source of self-esteem for an individual. The significance of familial relations and approvals are shown with one of Hezel’s statistics in his data: “Over 70 percent of all the suicides since 1960 were precipitated by conflicts within the consanguineal family” (Hezel, 55).

This phenomenon of high suicide rates among the male youth in Micronesia was first noticed by Reverend Francis Hezel, a Jesuit who was the director of Xavier High School in the Chuuk islands for nearly 18 years. Reverend Hezel wrote a magazine article about this phenomenon in 1977. Dr. Rubinstein, a researcher at Honolulu’s East-West Center, and Reverend Hazel later decided to research the issue further in the following years where they collected many facts about the situation but unfortunately did not come up with any solutions at the time. A later publication by Hezel in 1989 described the magnitude of the situation in Micronesia in comparison with the suicide rates of the United States: “The general suicide rate for Truk is 40 per 100,000. The rate for Trukese males between 15 and 25 is a startling 250 per 100,000. This is 20 times the youth rate in the United States” (Hezel, 1989).

Hezel observed that these suicides can be linked to small disputes between a young man and an older family member, like an older sibling or parent. Two examples were cited by Hezel to show his observation of the trend: one 13 year old boy hung himself after being scolded by his mother and a 16 year old boy also hung himself after his father refused to give him $1.

Another trend Hezel recognized was that the suicides would be clustered in groups; the death of one young man would often lead to suicides of others in the area. 

When thinking about possible causes for these trends, Hezel initially thought that the process of modernization and its pressures clashing with traditional island societies was responsible for this phenomenon. Hezel and Rubinstein looked further into the issue and found that poor family relations were a common pattern with their research. 

Hezel also described another insight into the issue that he gathered from his research: 

“Rather than an impulsive act, we found the suicides were often the result of a longterm intolerable situation”

(Hezel, 1983).

Reverend Hezel’s insight reveals that these suicides in Micronesia are not impulsive, but that there is a cultural aspect to the situation, regarding a traditional island defense mechanism taken to an extreme. The word “amwunumwun” is used by the Chuukese to describe the behavior of young men using withdrawal to express shame or anger. Refusing to eat or being silent are examples of actions that these young men engage in when showing this behavior. 

Reverend Hezel and Dr. Rubinstein believed that the strategy of amwunumwun became violent in the 1960s and 1970s where suicide might be considered the most extreme form of this behavior of bringing harm to oneself to save a relationship. A Chuukese suicide victim thought that being dead would repair more to a damaged relationship than if they were alive.In a later publication Reverend Hezel shed new insight on the suicide epidemic in the Chuuk islands (Hezel, 1989).

Figure 1

Note. Hezel found that anger was the leading cause of suicide in several islands in Micronesia (Chuuk, Pohnpei, Kosrae and Yap), the Marshall Islands and Palau (Hezel, 1989, p. 49).

Hezel also sought to find out the significance of the types of interpersonal and familial relationships that lead to suicide in Micronesia. Below is the table of his recorded data:

Figure 2

(Hezel, 1989, p. 51)

The table revealed that a relational disruption or conflict between a young man and his parents was often the most common cause of relational disruption that led to suicide. Hezel notes that in suicide cases that were led by disruptions in nonfamily relationships, the victim might break off familial ties because of the shame that might be bringing to their family and fear of what their family members’ reactions woud be. The victim was ashamed of actions that could offend their family and feared a consequential disruption in familial relations.

In 2007,  Dr. Mao-Sheng Ran, a professor at the University of Hong Kong, reviewed pre-existing data on the characteristics of suicide in Micronesia. 

Dr. Ran’s research found another phenomena that highlights the effect of mental health on suicide in Micronesia the effect of mental health on suicide in Micronesia compared with another country such as the United States.

Figure 3

(Ran, 2007, p. 83).

The bar graph above reveals an interesting and peculiar observation about the correlation between mental illness and suicide victims in Micronesia. Only 10% of suicide victims in Micronesia had psychiatric disorders, while 90% of suicide victims in the United States had mental illness. Dr. Ran states that:“Mental illness did not appear to be

an important factor in Micronesian suicides. Most of the victims have had no serious delinquency problems, psychological abnormality, or psychosis.”(Ran, 83) 

Dr. Ran noted that intergenerational conflict was the most common cause that led to suicide and most suicides occured because of a conflict, misunderstanding or argument between a young victim and their parents or older relative. 

The definition of anger in Hezel’s research is further explored in Dr. Ran’s review. Hezel’s publication in 1989 cited three distinct patterns of suicides which included anger suicides, shame suicides and psychotic suicides. It was previously mentioned in Hezel’s publication that anger suicides were the most prominent in Micronesian suicide cases, but this definition of anger adds a new understanding to the situation. Ran established that:”The definition of ‘anger’ was similar to the way Americans describe depression”(Ran, 2007, pg. 84). This definition of anger shows a cultural difference in how anger is defined in Micronesian society and American society. 

The review also included several aspects and social changes that may be responsible for the high suicide rate in Micronesia. The first change is the expansion of a cash economy in Micronesia and the decreasing reliance on subsistence production. The production may be responsible for weakening the significance of clan and lineage activities. The decline in clan and lineage activities narrows social support for teenagers, increases reliance and dependence on parents, and increases  parental-adolescent conflicts.The second change is the acceptance of suicide which can be attributed to this increase in suicide rates. As suicide becomes common among the youth, it became more acceptable and even expected.

According to Hezel, western solutions such as suicide prevention hotlines and counseling would not fully solve the suicide epidemic witnessed in Micronesia as the issue is not only psychological but also cultural. Dr. Ran offered several suggestions for future research to combat the issue. Ran suggests that there should be more surveillance on suicidal behavior in Micronesia, independent research on preventive and risk factors, and a longitudinal study on social and economic shifts affecting the male youth. Since there is not many mental health professionals available, Ran suggests that more individuals should be trained to counter the issue of suicide. 

The Micronesian suicide epidemic is quite unique as the root of the issue is concerned more with the inter-generational conflict and socio-cultural elements found within Micronesian society rather than mental illness. Solutions to the issue and research on the topic cannot be treated in a western approach, as the act of suicide has shown to be woven into the youth culture of Micronesian society. Future studies, research, and clinical approaches must consider the socio-cultural elements of Micronesian society & family to make progress in combating the Micronesian suicide epidemic.


References

Hezel, F. (1989). Suicide and the Micronesian family. The Contemporary Pacific, 1(1/2), 43–74. Retrieved November 30, 2020, from http://www.jstor.org/stable/23701892 

Micronesia’s male suicide rate defies solution. (1983, March 06). The New York Times. Retrieved November 30, 2020, from https://www.nytimes.com/1983/03/06/us/micronesia-s-male-suicide-rate-defies-solution. html 

Ran, Mao-Sheng. (2007). Suicide in Micronesia: A systematic review. Primary Psychiatry, 14(11), 80–87. Retrieved November 30, 2020, from https://www.researchgate.net/publication/262882325_Suicide_in_Micronesia_A_Systematic_Review

Rubinstein, D. H. (1983). Epidemic suicide among Micronesian adolescents. Social Science & Medicine, 17(10), 657–665. doi:10.1016/0277-9536(83)90372-6

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s