A newly released report describes disintegrating mental health among dozens of the more than 1,100 people being held by Australia on the Pacific island nation of Nauru.

Nauru

The tiny island nation is just 8 square miles and has only 10,000 citizens.

Map showing the location of Nauru in the Pacific Ocean

The report out Monday from Amnesty International is based largely on interviews conducted by Anna Neistat, a researcher working for the watchdog group, in July with 58 people being held on the island. It focuses on self-harm, calling it "shockingly commonplace."

One man told Neistat, who previously spoke to NPR about her time in Nauru, that he had taken actions to kill himself twice in 10 weeks. A woman who was confined to a medical ward on the island after setting her house on fire said she thought about ending her life almost all the time.

In August, The Guardian published more than 2,000 complaints detailing the alleged physical and sexual abuse of children held on the island, as The Two-Way reported. Over the weekend, Kingsley Woodford-Smith of the Australian department of immigration and border protection dismissed the complaints as "largely minor in nature or what a reasonable person would see as minor in nature," according to Australia broadcaster ABC.

The Amnesty report characterizes the overall scale of the mental health crisis on Nauru this way:

"Nearly all of the people whom Amnesty International's researcher met on Nauru in July 2016 reported mental health issues of some kind: high levels of anxiety, trouble sleeping, and mood swings were frequently mentioned. Almost all said that these problems began when they were transferred to Nauru."

The report also describes in detail the story of wrestling coach from Iran whose wife became deeply depressed on the island, and exhibited suicidal behavior when she was seven months pregnant. In September, NPR interviewed a person who seemed to be the same man — a refugee from Iran who said he had worked as a wrestling coach and whose wife had tried to end her life when she was seven months pregnant.

"She's all the time at home. She's crying, and she's not well," the man told NPR. "You know, I run away from my country because they want kill me straight away. And then I come to Australia. Australian government is kill me step by step, slowly, slowly. It's nothing different."

Because the Amnesty International report uses aliases to protect the identities of the individuals it describes (as did NPR in this case), it is impossible to know for sure if it is the same person.

One reason for the refugees' despair, the report says, is "the fact that they are trapped" and "face debilitating uncertainty about their future," pointing out that, although asylum seekers on Nauru are not technically detained, because they are free to move around, they are nonetheless unable to leave the 8-square-mile island.

A 19-year-old Syrian refugee who had been held on the island for three years told Amnesty, "I felt like I was a slave. Being detained is like feeling you did something wrong — like you are a criminal."

Asylum-seekers are held by Australian authorities on Nauru indefinitely for attempting to get to Australia by boat. Even if authorities determine they qualify for refugee status, under Australia's strict migration laws people held on Nauru are not allowed to settle in Australia.

The report notes that, although Nauru is not Australian soil, "Australia retains at a minimum joint responsibility – and likely principal responsibility – for the human rights of asylum-seekers and refugees on Nauru." It also notes there is only one hospital available to the people held on Nauru, which is run by a private company contracted by the Australian government, and which Amnesty says is "ill-equipped to deal with serious emergencies."

As we have reported, Australia's highest court effectively upheld the offshore policy in February when it threw out a legal challenge to offshore refugee detention centers.

In an interview with NPR in September, Australia's immigration minister, Peter Dutton, credited the policy with reducing drowning deaths in the past two years. "We already have one of the biggest intakes of refugees in the world," he said "but the reality is that we provide a humane and safe environment for people."

Copyright 2016 NPR. To see more, visit NPR.

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