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Cited by 40Suicide and Self-Harm StudiesHomicide, Infanticide, and Child AbuseInjury Epidemiology and Prevention

Suicide and suicide attempts in the Pacific Islands: A Systematic Literature Review.

Open access
Mathieu, Sharna, de Leo, Diego, Koo, Yu Wen, Leske, Stuart, Goodfellow, Benjamin, Kõlves, Kairi·2021·The Lancet Regional Health - Western Pacific
DOI 10.1016/j.lanwpc.2021.100283PMC PMC8495100
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Abstract

BACKGROUND: The Pacific Islands have some of the highest rates of suicide in the Western Pacific region. The purpose of this study was to systematically review the literature on suicidal behaviour in the Pacific Islands. METHODS: February 2021. Inclusion criteria included papers that referred to a pre-specified list of Pacific Islands. Papers referring exclusively to other countries were excluded. Other exclusion criteria included not being about suicide or suicide attempts or not presenting original research. Narrative synthesis was applied without meta-analysis. The review followed PRISMA guidelines. FINDINGS: A total of 36 papers were included for review. Of the Pacific Islands, Kiribati has the highest age-standardised rate of suicide mortality. Key risk groups across the Islands included youth, people of Indian ethnicity in Fiji (a prominent ethnic group in Fiji), and Indigenous peoples across other Islands. Prominent methods were self-poisoning and hanging. A distinct lack of intervention studies was found. INTERPRETATION: Overall, the Pacific Islands appear to have relatively high rates of suicide and suicide attempts compared to other countries in the region. This was particularly striking among youth. This review provides important directions for future suicide prevention activities, including means restriction, sensitive media/community coverage, enhanced surveillance, and the development and evaluation of interventions tailored to the needs of young people and other cultural groups. FUNDING: None.

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  • The Pacific Islands have one of the highest suicide rates worldwide.

    “which have one of the highest rate in suicide worldwide.”

    From Colonial transition as a major mediator of global health transition: lessons from the 2024 New Caledonia crisis (2025) · cites this paper as [23]

    The Introduction says the Pacific Islands have some of the highest suicide rates in the Western Pacific Region, and that several islands exceed the global average. It does not establish that the islands have one of the highest suicide rates worldwide; the Results’ global comparison concerns youth suicide attempts, not suicide deaths. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • Mental health disorders emerge as a significant concern during the colonisation transition, in line with mechanisms discussed by Fanon.

    “In view of NCDs, mental health disorders emerge as a significant concern during the colonisation transition, in line with the mechanisms discussed by Fanon [23].”

    From Colonial transition as a major mediator of global health transition: lessons from the 2024 New Caledonia crisis (2025) · cites this paper as [23]

    The Discussion (page unavailable) treats mental health conditions as relevant to suicidal behaviour and recounts earlier studies linking social disintegration to rapid urbanisation and Westernisation. The Results (page unavailable) also describe suicide among Indian-Fijians in relation to a history of colonisation and indenture. The review does not establish that mental health disorders emerge during a colonisation transition or discuss Fanon's mechanisms. (LLM, conf=0.82)

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  • Studies conducted in New Caledonia reported specific alcohol and drug abuse challenges, as well as high rates of suicide for young Kanak males.

    “Studies conducted in New Caledonia reported specific alcohol and drug abuse challenges, as well as high rates of suicide for young Kanak males [23–25] (Table 1).”

    From Colonial transition as a major mediator of global health transition: lessons from the 2024 New Caledonia crisis (2025) · cites this paper as [23]

    The Results (Study details; page unavailable) report that Indigenous Kanak people were overrepresented in suicide deaths, that the male-to-female suicide ratio was 1.7, and that alcohol or other substance-use disorders were among the most common diagnoses. The review does not establish a high suicide rate specifically for young Kanak males, and its substance-use finding concerns people who died by suicide rather than alcohol and drug abuse in the wider population. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

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Authors
Mathieu, S., de Leo, D., Koo, Y. W., Leske, S., Goodfellow, B., & Kõlves, K.
Affiliations
Griffith University (AU)
Corresponding author
Kõlves, Kairi
ORCID
Venue
The Lancet Regional Health - Western Pacific
Publisher
Elsevier BV
Published
2021-12
Volume
17
Pages
100283
ISSN
2666-6065 (ISSN-L)
DOI
10.1016/j.lanwpc.2021.100283
PMC
PMC8495100
OpenAlex
W3203077706
Cited by
40
References
68
Citations by year
2026: 5 · 2025: 6 · 2024: 11 · 2023: 10 · 2022: 6 · 2021: 1
FWCI
0.93
Type
journal article
Language
en
Open access
Licence
Locations
  • The Lancet Regional Health - Western Pacific (publishedVersion, cc-by-nc-nd)
  • Europe PMC (PubMed Central) (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Griffith Research Online (submittedVersion, cc-by-nc-nd)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Injury Epidemiology and Prevention
Keywords
suicide, suicide attempts, Pacific Islands, suicide mortality, youth suicide, indigenous peoples, Indian ethnicity, Fiji, Kiribati, self-poisoning, hanging, suicide prevention, means restriction, media coverage of suicide, suicide surveillance

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