南太平洋海域調査研究報告 No．
３６（２００２年１２月）
OCCASIONAL PAPERS No．
３６（December ２００２）

３３Youth Suicide and Social Change in Micronesia

Donald H．RUBINSTEIN

Kagoshima University Research Center for the Pacific Islands
The Micronesian islands in recent decades have experienced an extraordinarily high incidenceof youth suicide. Among the age group at greatest risk−young men between １５ and ２
４ yearsold−suicide rates in Micronesia surpass reported rates from any other region within Asia andthe Pacific Islands. Indeed, the youth suicide rates in Micronesia have achieved the tragic
distinction of being among the highest in the world. This paper describes some of the researchon youth suicide in Micronesia, and summarizes some of the relationships between epidemic
youth suicide, social change, and culture in Micronesia （see also Rubinstein １
９８３, １９９２a,
１９９２b, １９９５）.
The area of Micronesia under discussion here includes Palau, the Federated States ofMicronesia（FSM）, and the Marshall Islands （Map）. Within this area, there are about fifteen
different languages spoken, and significant cultural differences exist from one main island group
to another, such as Palau, Yap, Chuuk, Pohnpei, Kosrae, and the Marshall Islands. Not includedin this study are the US Territory of Guam and the US Commonwealth of the Northern Mariana
Islands, which are culturally and historically quite distinct from the rest of Micronesia. Also notincluded in this study are the independent republics of Nauru and Kiribati, which also have hada different colonial and cultural history. For the purposes of this discussion, then, Micronesia
refers only to Palau, the four states of the FSM, and the Marshall Islands.

The cultures and languages of the islands within this area show extensive variation, because
the area was originally settled from quite different directions and at different time periods（Denoon １９９７）. The western Micronesian high islands of Yap and Palau-as well as theMariana Islands−were settled directly from Southeast Asia, about ３, ０００ or ４, ０００ years ago.

３４

Donald H. Rubinstein

The eastern coral islands of the Marshalls and Kiribati were settled more recently, perhaps two
thousands years ago, by islanders from eastern Melanesia, who then expanded westward down
the Caroline Islands chain through Kosrae, Pohnpei, Chuuk, and the neighboring low-lying coralislands. For the first several thousand years of their history, Micronesians developed distinctive
cultural adaptations to their island environments, with nearly no contact from the outside world.
Within the past ２
００ years, however, these quite different island societies have experienced afairly similar history of colonization and culture change（Hezel １９８３）. During the １
８００s theislands were exposed to Western missionaries, traders, and whalers. Many of the islands
suffered devastating depopulation from introduced diseases, mainly smallpox, measles, andinfluenza. In some cases, depopulation continued into the early １９００s, and the populations did
not begin to recover from the impact of infectious disease until the mid-１９００s after the Pacificwar, when Western medicine and antibiotics were introduced（Taylor et al １
９８９）.
Within less than a century the islanders underwent four different colonial regimes, first
Spanish, then German, followed by Japanese and finally American. The colonial governmentthat had the greatest impact has been the American regime, which began immediately afterWorld War II. Especially during the period following the mid-１９６０s, social change accelerated
in Micronesia as the American colonial administration greatly increased budgets for the islands
and extended hundred of US federal program to include Micronesia.
These changes touched every aspect of Micronesian societies. American-style schools werebuilt on every island. American cultural influences arrived as well with movies and television,and thousands of Peace Corps Volunteers. US federal education grants enabled thousands ofMicronesian college students to study in the United States.
In addition to these cultural changes taking place, fundamental economic changes were
occurring. A rapid increase in paid employment came about with the creation of thousands of
new jobs for schoolteachers, office workers, and laborers. The economy began to shift from a
subsistence economy based on family gardening and fishing, to a cash economy based on wage
labor and imported foods and products. In the Micronesian islands, land traditionally has been
owned and used by families or lineages （which are extended kinship groups）. The change ineconomy from family-based subsistence to individual wage labor set in motion fundamental
changes in the very structure of Micronesian families（Hezel１
９８９）.This fact has been of central
importance to the research on adolescent suicide, and I ll come back to it later.
By the early １
９７０s, several social problems of youth in Micronesia began receiving attention.
Alcohol drinking among young men was one cause for concern, and led to a number ofgovernment research reports and conferences. The Micronesian islands before foreign contact
did not produce any alcoholic beverages, so alcohol is a historically recent product（Marshall
１９９３）. During the colonial eras alcohol consumption by the islanders was regulated or
prohibited. As these restrictions were lifted during the １
９６０s American administration, alcohol
use and abuse among youth appeared on the increase （Marshall and Marshall１９７５）. A second
problem, closely related to alcohol use among youth, was an increase in juvenile delinquency inMicronesia that was noted in the early １
９７０s（e. g. Kenney １９７６）.
Adolescent suicide in Micronesia did not receive general notice until １９７６. In that year, apaper was published by Francis Hezel−a Jesuit priest and historian who ran a small CatholicYouth Suicide and Social Change in Micronesia

３５agency for social research and action, and who also directed a Jesuit high school in Chuuk.
Using preliminary data from his students, Hezel noted what appeared to be a sudden increase inyouth suicide among Chuukese youth, and he speculated that the increase in suicide mightsomehow be related to recent social changes in Micronesia（Hezel １９７６）.
At the time that Hezel s paper appeared, I was doing my doctoral dissertation field researchon the small coral island of Fais in Yap State. Fais Island at that time was one of the mostremote and isolated of the Micronesian islands, and the island had experienced very little of thesort of social change that was occurring in the district centers in Chuuk and elsewhere.
Surprisingly, however, I had discovered that a number of suicides had occurred on Fais. The
most recent was an １
８-year old girl who hanged herself in １
９７２.
Two years later, when I had finished my research on Fais Island, I met with Father Hezel andwe planned the first research project on suicide in Micronesia. At that time, a primary question
was whether suicide really was increasing in Micronesia, as Hezel s １９７６ article assumed, orwhether there had always been high rates of suicide in Micronesian islands, as my Fais
experience suggested. In other words, was suicide an epidemic, with recent rates rising above
normal, or was suicide an endemic feature, perhaps related to the stress of small island life, or aculturally patterned way of resolving conflict ？
To answer this question we conducted an epidemiological survey throughout Micronesia overa two-year period １
９７９-１９８１. We collected all the available official statistics from hospitalrecords and court certificates of deaths, and we followed up these official data by interviewing
hundreds of families and friends of suicide victims in all the major Micronesian island areas.
The survey was retrospective, in that we also tried to reconstruct the past history of suicides ineach of the island communities, as far back as people could remember. The survey followed theguidelines of what has been called psychological autopsies in suicide research. We tried to get
information on the person s family background, education, work history, health, use of alcoholor drugs, mental problems, and the events leading up to the person s suicide, and how thesuicide actually occurred.
Our survey research confirmed beyond question that Micronesian suicide rates have risen in
epidemic fashion since the １
９６０s（ Fig.１）. From the survey, several epidemiological trends
became quite clear. First of all, from the early １
９６０s to the early １
９８０s, suicide rates overall in
Micronesia had increased in classic epidemic fashion, more than doubling every decade, from
the １
９６０s to the １
９７０s, and from the １９７０s to the １
９８０s. The most rapid increase had occurred
during the １９７０s. By the early １
９８０s the rate of increase had slowed but overall Micronesiansuicide rates were still rising.
The survey research also demonstrated that suicide rates among Micronesian men wereapproximately seven or eight times higher than among Micronesian women. In most countries in
the world, men commit suicide more frequently than women, but the differences in rates areusually not so extreme as what we found in Micronesia.
The research also revealed that the high suicide rates were very narrowly focused among
young men, mainly between the ages of １５ and ２４（Fig.２）. In comparison with most othercountries, this pattern is highly unusual. In most populations, suicide rates generally increase
with age, and the highest rates are almost the oldest members of the population. In someDonald H. Rubinstein

３６countries there is a bi-modal distribution of suicides, showing highest rates among the elderly,
and a minor secondary peak among youth. But cross-culturally, it is very unusual to find that thehighest suicide rates are among young adults.
Fig.１

Fig.２

Fig.３

Youth Suicide and Social Change in Micronesia

３７

In Micronesia we found that the modal age for suicide was ２
０ years old, and among thisgroup, the rate was over １００ per １００, ０００ annually. This rate is about five times higher than therate among young Japanese men, which is already high by world standards（Fig.３）. Among thedifferent Micronesian island groups, rates varied from place to place, suggesting culturaldifferences influencing suicides. The highest rates were found in Chuuk, where young men aged
１５-２４ had suicide rates over ２００ per １００, ０００ annually. This means that during the ten-year
period from age １５ to ２４, １ in ４０ Chuukese boys commit suicide. Suicide had become theprimary cause of death for Micronesian youth. These rates were extraordinarily high.
We also found an interesting pattern of geographic variation. Social change in Micronesia ismost advanced in the district centers and port towns on the main islands. In the rural outerislands, the traditional ways of life have changed much less. Suicide cases generally in the outerislands appeared very rare. （My field site of Fais Island proved to be an unusual exception）.
But most significantly, the highest rates of suicide appeared not in the most urban and developed
centers, but in those communities lying midway along the spectrum from rural to urban. The
association between high suicide rates and social change did not appear to be a simple, linear
relationship.
The survey also revealed a general profile of the suicide victim. The typical suicide victim
was a young man, aged ２０ or so, living at home with his parents. Generally these young men
appeared normal in terms of their health, mental condition, and behavior. We found no obvious
patterns of physical or psychological illness among the suicide victims. In fact, many appeared
to be obedient sons who were well liked by their friends. Certainly these young men weregenerally not identifiable as rebels or outcasts. The method of suicide was almost always by
hanging, and in many cases the feet were still touching the ground. The person simply slipped
his head into a rope noose that he had tied to a tree branch or roof beam, and by leaning forward
into the tightening noose, he stopped the blood supply to the brain, and quickly lost
consciousness and died within a few minutes. The suicidal acts often had a quiet, retreatist
aspect.
Alcohol is part of the suicide motivation or method, but the correlation is not particularly
strong. In about one-third to one-half of the cases, the young man was drinking alcohol at thetime of the suicide, and about the same percentage of cases revealed a past history of fairly
heavy drinking. But these percentages are probably about normal for young Micronesian men,so the suicides do not appear distinctively associated with alcohol abuse.
Typically, the suicide occurred without warning or prior communication, and the family andfriends of the suicide victim were quite surprised. There was very little evidence of suicide
threats or attempts that might serve as a cry for help or as a warning to friends or family
members that the person was considering suicide. Indeed, many of these suicides appeared to bevery impulsive acts rather than premeditated or planned actions.
The typical triggering event for the suicide was a quarrel or argument between the young man
and his parents, or occasionally an older brother or sister, or some other older relative. Often thepreceding event seemed oddly trivial, and the response of suicide appeared totally out of
proportion. For example, a father scolds his son for staying out too late, or for asking for a few
dollars to buy something, and the son runs off and hangs himself. The events did not sound like

３８

Donald H. Rubinsteinmajor crises in a young man s life, but they suggest a deeper pattern of conflict between young
men and their parents or other immediate family members in authority. These triggering events
for suicide were always located within the close family. It was never the case a young
Micronesian man committed suicide after being scolded by a policeman, or a teacher, or someother authority figure outside the family.
This profile of the typical Micronesian suicide raises several important questions. Why should
the suicide rates be so much higher among men than women in Micronesia? And why especiallyamong young men? How have relations within Micronesian families become troubled in waysthat lead frequently to adolescent suicide? These questions are impossible to answer withcomplete certainty, because the factors influencing suicide are too complex to reduce to simple
causal models.
It does appear that recent social changes in Micronesia have been more stressful for men thanfor women. Women s roles traditionally in Micronesia centered around taking care of the house,taking care of the children, and preparing food. These are still important aspects of family life,
and women s work in fulfilling these roles is still valued in Micronesia. Men s roles
traditionally in Micronesia involved fishing, and the heavy labor of gardening. Men provided thefood through their subsistence labor, while women prepared the food and took care of the house.
Increasingly, the role of food provider in the subsistence economy has been replaced by the roleof wage earner in the cash economy. Men s traditional roles in Micronesia have been much
more weakened and transformed during the course of recent social changes than women s
traditional roles.
The question remains, however, why should young men aged １５-２４ be at the greatest risk forsuicide? Here also the answer may lie in recent social changes in Micronesia. The stage of life
between the ages of １
５ and ２４ correspond roughly with the age when a boy reaches sexual
maturity, to the age when he gets married. Traditionally in Micronesia, this was a somewhat
difficult and unstable period for the males. At sexual maturity, boys usually moved out of theirparents house, because in most parts of Micronesia it was taboo for a sexually mature boy tosleep in the same house as his sisters. Commonly, the sexually mature boys would sleep in acommunity men s house, or in a bachelor house for young unmarried men, or they would sleep
with extended family relatives such as uncles or aunts. At marriage, the young men typicallywould move into their wife s house and live on her land.
One effect of the gradual shift from subsistence gardening to wage labor has been aweakening in the lineages or kin groups which owned the garden land and maintained thecommunity men s houses. The nuclear family with its wage-earning head has become more
important than the extended kin group that formerly owned land and worked it communally.
Along with this change, the community men s houses in many islands are no longer kept up,
and the extended relatives are no longer so actively involved in a young man s life. As a result,young men now do not have places where they can conveniently stay if they move out of theirparents house. They must remain at home, despite occasional conflicts with their parents overauthority and resources. The traditional social supports for young men−which were thecommunity houses and the extended family−have largely disappeared, and young men havelost much of their former independence and role in their communities.

Youth Suicide and Social Change in Micronesia

３９Another important question is, Why did the Micronesian suicide rates begin rising just aroundthe mid-to-late １
９６０s? Knowing as we did that the high risk period was from １５ to ２４ years ofage, and the main cause of suicide appeared to be conflict between young men and their parents,
we believed that the suicide epidemic might be a one-generation cohort effect（ Fig.４）. Thatis, we thought that perhaps the suicides were associated with the first postwar generation ofyouth, those born beginning in １９５０ and first reaching sexual maturity around the mid-１９６０s.
Growing up in very different social conditions from their more traditional parents, perhaps theirsuicides were an expression of the cultural differences and increasing conflict between these twovery distinct generations. If this really was a one-generation cohort effect, then a theoreticalmodel would predict that the suicides rates would rise in the mid-１９６０s when the first membersof the cohort entered adolescence, and the suicide rates would fall by the mid-１９９０s, when thelast members of the cohort completed adolescence and settled down into marriage. Thus the
hypothetical model−and I emphasize hypothetical−would show the suicide rates peaking
around the early １
９８０s and then falling as rapidly as they had increased.
Fig.４

By the mid-１９８０s when we examined new data, it appeared that in fact the suicide rates in
Micronesia had peaked and begun to turn downwards and were returning to the lower rates ofthe late １９７０s（Fig.５）. It seemed that our hypothesis about a one-generation cohort effect wascorrect, and the suicide epidemic was waning.
Fig.５

Donald H. Rubinstein

４０

But during the next few years suicide rates increased sharply in Micronesia, proving
unfortunately that our hopeful hypothesis was wrong（Fig.６）. The actual epidemic was more
complex than a simple one-generation effect. Part of the complexity likely stems from cultural
factors. In addition to the social changes in family organization and economy and men s roles
that I have already described, changes have occurred in the subculture of youth, and in thecultural meanings associated specifically with youth suicide. As suicide has gained familiarity
among youth, the act itself has become increasingly more acceptable or even expected. Suicides
appear to acquire a sort of contagious power. One suicide might serve as the model for
successive suicides among friends of the first victim. There has been an apparent increase insuicides among very young children, aged １
０-１４. Evidently the idea of suicide has become
increasingly commonplace and compelling, and young children are now acquiring this idea atearlier ages.
Fig.６

The complexity of social and cultural factors influencing suicide in Micronesia makes the
problem especially difficult and disturbing. The suicide epidemic appears to have begun as avery culturally patterned response of youth to conflicts arising within a changing family
structure. And once begun, the suicidal acts seem to have acquired a psychological contagion of
their own. The youth suicide phenomenon in Micronesia is now entering its third decade, withno signs of any significant reduction. The tragedy of such an enormous and unnecessary loss oflife−even more so because they are mostly young lives−continues to challenge healthprofessionals and social leaders in Micronesia.

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７-６９.
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Hezel, Francis X. １
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９８３. The First Taint of Civilization：A History of the Caroline and Marshall Islands in
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Donald H. Rubinstein