Warning: This story discusses suicide and contains details that may upset some people
The situation on Papua New Guinea's Manus Island is reaching breaking point under the strain of refugee suicide attempts and self harm, an advocate says.
About 500 refugees are still detained on the island as are about 300 on Nauru under the Australian government's offshore processing regime.
During six years of indefinite detention without trial, the refugees have been ravaged by a mental health crisis gauged by the United Nations as the worst among refugee groups anywhere in the world.
Refugee Shaminda Kanapathi reported two cases of self-harm today on Manus, where refugees have recorded about 100 suicide attempts and incidents of self harm since the Australian election on 18 May.
Advocate Ian Rintoul said one refugee had swallowed nail clippers and was taken to the local hospital.
Guards initially refused to transport him because the hospital was overcrowded, Mr Kanapathi said.
Then a few hours later, an asylum seeker, who had been refusing food for several days, cut his head, Mr Rintoul said.
Over the weekend, there were another five incidents of self-harm in Manus and in Port Moresby, where refugees are being treated at Pacific International Hospital (PIH), Mr Kanapathi said.
A 31 year-old Indian asylum seeker, who set fire to himself and his room on Friday, was transferred to the PIH intensive care unit on Saturday along with two other Manus refugees, Mr Rintoul said.
About 14 men who have attempted suicide are being held by Manus police in what's known as the Shamrock compound, he said.
Others, exhibiting the symptoms of "resignation syndrome", are refusing food, water and social contact.
The desperation of the Manus men was highlighted last Thursday, when a man from Sudan mounted a protest on World Refugee Day by climbing a cell phone tower.
The refugee scaled the 30 metre tower and refused to descend for about four hours while threatening to throw himself to his death.
Other refugees reported the man was depressed and angry over a two year delay with his application to be resettled in the United States.
They said he eventually came down after negotiating with PNG immigration officials.
Earlier that week, another refugee from Sudan threatened to set himself on fire over a similar delay.
Where to get help
These are services across the Pacific for people who may be thinking about suicide, or those who are concerned about family or friends.
In Tonga Lifeline 23000 or 25144
In Fiji Lifeline +679 667 0565
In Papua New Guinea Lifeline Port Moresby +675 326 0011
In Samoa Lifeline 800-5433
In New Zealand:
Lifeline: 0800 543 354
Suicide Crisis Helpline: 0508 828 865 / 0508 TAUTOKO (24/7). This is a service for people who may be thinking about suicide, or those who are concerned about family or friends.
Depression Helpline: 0800 111 757 (24/7)
Samaritans: 0800 726 666 (24/7)
Youthline: 0800 376 633 (24/7) or free text 234 (8am-12am), or email firstname.lastname@example.org
What's Up: online chat (7pm-10pm) or 0800 WHATSUP / 0800 9428 787 children's helpline (1pm-10pm weekdays, 3pm-10pm weekends)
Kidsline (ages 5-18): 0800 543 754 (24/7)
Rural Support Trust Helpline: 0800 787 254
Healthline: 0800 611 116
Rainbow Youth: (09) 376 4155
If it is an emergency and you feel like you or someone else is at risk, call 111.