It is mid-morning and Chief Inspector David Yapu is sitting in his upstairs office at the Manus Police Headquarters, overlooking the ocean, when the call comes in.

Key points: Men who lived in Australian detention on Manus say there's been a spike in self-harm

Men who lived in Australian detention on Manus say there's been a spike in self-harm Manus Governor Charlie Benjamin has called on Australia to remove the remaining men

Manus Governor Charlie Benjamin has called on Australia to remove the remaining men The Home Affairs department says it works closely with PNG to ensure transferees have appropriate health services

Another suicide attempt.

A group of his officers rang to inform him they were taking a refugee from one of the three accommodation centres on the island to the health clinic.

It was the latest in a recent string of similar incidents.

"We've seen a number of cases of attempted suicide, self-harm, and that is something. It's a surprise to us because it's been happening within a short period of time," he said.

Just days after police respond to this suicide attempt, a Somali man set himself on fire.

He was briefly hospitalised before being discharged.

Chief Inspector Yapu said police are limited in what they can do, and he wants the PNG and Australian governments to step in.

"This is something that's beyond our control," he said.

"If we see one lose his life, our reputation and our credibility will be questioned, how best have we dealt with the situation."

After almost six years and with the self-harm incidents escalating, he is not alone in calling for an intervention.

Locals are starting to speak out about the pressure it is putting on the island.

Now, Governor of the Manus Province Charlie Benjamin is also calling for action from the Australian Government.

"They don't want to be here and Australia, you have to take responsibility. You have to move them," he said.

Paramilitary police deployed to handle spike in incidents

There has been a dramatic increase in self-harm and suicide attempts among the refugees and non-refugees in Papua New Guinea since the Australian election.

Many had pinned their hopes on Labor winning the election in May.

The Labor Party had promised that if elected, it would accept New Zealand's offer to take 150 refugees out of Australian offshore detention.

Some thought they may even get to Australia, despite both sides of politics ruling that out.

Behrouz Boochani (centre) is working with a small group of men to document the incidents. ( ABC News: Natalie Whiting )

Refugee and author Behrouz Boochani is part of a small group of men on Manus documenting the recent incidents.

"About 50 people attempted suicide and self-harm in Manus and some of them in Port Moresby," he said.

"So far, five people transfer to Port Moresby and right now that I am talking with you, at least eight people are [being kept] in isolation."

He said people have "completely lost hope".

"My big concern and worry is about their safety," Manus police chief David Yapu said. ( ABC News: Natalie Whiting )

It is more than the local police can handle.

Chief Inspector Yapu said one of PNG's mobile squads — the paramilitary arm of the country's police force — had been brought in and was patrolling the accommodation centres and responding to self-harm reports.

"My big concern and worry is about their safety, because once they do something drastic and they lose their life, life is gone — you will never get a life back."

PNG's mobile squads have a fearsome reputation and have been accused of using excessive force in the past, but the police commander said they have been vital in recent weeks.

A mobile unit from PNG's paramilitary squad is on Manus, responding to the self-harm incidents. ( ABC News: Natalie Whiting )

"I've not had any allegations [of] overuse of the force. They've been dealing with the refugees in a professional manner," he said.

As of February, there were more than 570 refugees and non-refugees still in Papua New Guinea.

After the detention centre closed in 2017, they are now able to move around the Manus province freely.

Some of the refugees have been accepted to live in the United States and the Australian Government said the others will have to settle in Papua New Guinea.

But few have set up lives here.

"This country is not capable to accept refugees and provide the situation to start a new life here," Mr Boochani said.

Refugee Kanapathi Shaminda said refugees who had been rejected for resettlement in the US were often the ones self-harming.

"They don't know what their future is going to be, and the situation is like a limbo," he said.

"So, they are the ones who are mostly attempting suicide or self-harm."

Advocates say the election result was "the last straw" for people who already had serious mental health conditions.

The Asylum Seeker Resources Centre (ASRC) is working with other organisations to facilitate medical transfers under the new "medevac law".

The group said almost 70 people from Nauru and PNG have been transferred, or approved for transfer, since the bill passed.

The cases are a mix of mental health and other medical conditions, with some cases processed under the old system, and some under the new medevac procedure.

The ASRC said the process of deciding who is put up for a medical transfer is being based solely on the decision of doctors, rather than which cases are in the media.

'They're bringing their protest to our doors'

While there is a medical centre for the men on Manus, they often end up at the local hospital - particularly if an incident occurs after hours or is serious enough to require a transfer to Port Moresby.

Manus Hospital often treats refugees and non-refugees. ( ABC News: Natalie Whiting )

It sometimes means all of the four emergency beds, which are intended for locals, are taken up.

The Hospital's acting CEO, Dr Otto Numan, said the hospital was managing the periods of increased demand.

But he said it would have been good if Australia had funded an expansion or new hospital for the island.

Dr Numan said he is seeing more cases of self-harm than suicide attempts.

"They're bringing their protest to our doors," he said.

"They want to get to Australia, and nobody is listening to their pleas, so instead they're coming to the hospital to protest and I think the hospital is the wrong place to do that."

He said there are cases of depression among the remaining men.

"They're bringing their protest to our doors," acting hospital CEO Dr Numan said. ( ABC News: Natalie Whiting )

"Of course, if people have been in a place for too long, you get mentally affected also," he said.

The doctor said the asylum seekers were considered "Manus gold" because of the money and jobs they have brought to the community.

"I may have a conflict of interest because if they're taken away all those people who are being employed will miss out and that's a concern to me," he said.

"If they don't have the means to make a living, then they're going to move to the social problems like stealing and harassing people."

'I want them to leave'

Despite the jobs and money, many locals are calling for the remaining refugees and non-refugees to be removed from Manus.

At the seaside markets where people sell vegetables, there was a strong sentiment.

Some Manus locals want the men who were in Australian detention to leave their island. ( ABC News: Natalie Whiting )

"I want them to leave," one seller said.

Another said they hadn't been consulted when the men were brought to the island.

"For us the people, we didn't know about it, the decision came from the top in Port Moresby between Australia for the asylum seekers to come to us in Manus, but we don't need them here," the seller said.

One man buying some produce acknowledged the jobs the asylum seeker processing had provided, but said he now wanted to see it finish.

"It's been six years, so the governments of PNG and Australia need to find a place to resettle them now," he said.

Pressure on the hospital and relationships between the men and local women have been particular concerns for many people.

Manus Governor Charlie Benjamin said many locals don't understand why the refugees are "complaining".

"To us Manusians, the refugees are living a very good life, they have a place to stay, security, three meals a day," he said.

"But we understand that they want to move on, they have families and they want to settle down and bring their families with them."

Manus issue to be raised with PNG's new PM

Mr Benjamin said he expected that the asylum seekers would all have been processed and moved on by now.

"Unfortunately, that is not what is happening. Unfortunately, they also don't want to stay in Papua New Guinea and that makes it even harder," he said.

Manus Governor Charlie Benjamin said Australia must remove the men remaining on the island. ( ABC News: Natalie Whiting )

Mr Benjamin called on Australia to get involved.

"I think the Australian Government should do something about it — immediately," he said.

Mr Benjamin was concerned by the recent suicide attempts, the damage to Manus's reputation as a safe and welcoming place, and the social problems he said the project had brought.

He wants the Australian Government to remove the remaining men.

"The PNG Government can't do much and [Manus] can't do much. If we allow them to stay here, we will get even more problems, nothing will be solved," he said.

"We have to solve this problem and the only way to solve this problem is for Australia to act."

The Governor said he will be raising the issue with the country's new Prime Minister, James Marape.

Mr Benjamin was a key backer of Mr Marape, who took office less than a fortnight ago.

"Definitely I will be raising it with the new Prime Minister, honourable James Marape, and I'll get him to talk to the Australians," the Governor said.

In a statement to the ABC, the Home Affairs Department said it continues to "work closely with the governments of PNG and Nauru to ensure transferees are provided with appropriate health and welfare support services."

"The Australian Government is committed to supporting the governments of PNG and Nauru by providing specialist and wide‑ranging health, welfare and support services."

The department also said healthcare for the men in PNG was provided through the Pacific International Hospital (PIH), a private hospital based in Port Moresby, which also operates the medical clinic on Manus.

It said PIH has a dedicated mental health care facility and that $448 million had been spent since 2012 to improve offshore health services in Nauru and PNG.

It also said that healthcare on Nauru is available 24 hours a day and includes emergency services.

"The Australian Government supports the Government of Nauru by contracting specialist health services, which include, but are not limited to, psychology, psychiatry, trauma counselling, dentistry, radiography, pharmacy services and physiotherapy."