Pacific leaders opened their annual diplomatic summit in Nauru Monday, but the ceremony was overshadowed by allegations that children of asylum-seekers on the tiny Pacific island have been traumatised by systemic abuse.

Nauru President Baron Waqa formally welcomed delegates to the 18-nation Pacific Islands Forum, saying the summit was a chance to demand the world take urgent action on global warming.

However, when the Nauruan leader faced a rare grilling from the media, questions centred on the plight of those detained on the remote island under an agreement with Australia.

A report released Monday said the mental health of asylum-seekers was buckling under the strain of indefinite detention, adding that "those who have seen this suffering say it is worse than anything they have seen, including in war zones."

"People are broken," said the report, co-authored by the Refugee Council of Australia and the Asylum Seeker Resource Centre.

"Children as young as seven and 12 are experiencing repeated incidents of suicide attempts, dousing themselves in petrol, and becoming catatonic."

The report estimates there are 900 asylum-seekers on Nauru, including more than 100 children.

They are in Nauru as part of Canberra's tough immigration policy, which sees asylum-seekers who try to reach Australia by boat detained and processed in remote camps on Nauru and Papua New Guinea.

Psychiatrist Louise Newman said many children on Nauru -- the report estimates at least 30 -- were suffering from "traumatic withdrawal syndrome" because they could see no end to their plight.

"(It) is found in children exposed to ongoing trauma where they feel hopeless and helpless, resulting in a giving up on engagement with the world," she said.

Waqa said he had seen no evidence of mental health syndromes among refugee children. "They're living among us and running their lives just like any other Nauruans," he said.

"They're provided all the services that are provided to Nauruans and we live together very happily."

The summit will continue until Thursday, with delegates expected to issue a communique calling for action on climate change.

The Pacific is on the frontlines of the issue, with some island nations fearing they will be swallowed by rising seas and others repeatedly lashed by fierce storms that grow more intense as the weather changes.

"Climate change is already here, it's not just coming in the future," Waqa told reporters.

"We're working extremely hard, especially the small island states, to advocate to the world that something has to be done right away."

Other issues on the agenda include regional security, fighting obesity in the world's fattest region and China's rising influence in the region.

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