Background Evidence from European countries indicates a significant rise in suicides from the economic recession, totalling more than 1000 excess deaths in the UK alone. Among the worst affected economies in Europe, such as Greece, suicides have risen by more than 60% since 2007. Thus far, there has been little or no analysis of US mental health data, mostly owing to delays in data availability.

Methods We use data on suicide mortality rates from 1999 to 2010 from the Centers for Disease Control and Prevention. Unemployment data come from the Bureau of Labour Statistics. Time-trend regression models were used to assess excess suicides occurring during the economic crisis—i.e., deaths over and above the level that would be expected if historical trends continued.

Results In the years before the onset of the crisis (from 1999 to 2007), the suicide mortality rate in the USA was rising on average at a rate of 0·12 per 100 000 per year (95% CI 0.09, 0.14). Coinciding with the onset of the recession, the suicide rate accelerated. There were an additional 0·51 deaths per 100000 per year (0.28, 0.75) in 2008–10. This acceleration corresponds to an additional 1580 suicides per year (860, 2300). Thus, during the recessionary period after 2007, there were an estimated 4750 excess suicide deaths (2750, 6920). Next we investigated the association between rising unemployment and suicide mortality rates. A one percentage point rise in unemployment is associated with a 0·99% increase in the suicide rate ([0.60, 1.38], p < 0.0001), which is closer to the association estimated when there were no labour market protections (1·06%).

Conclusion Our findings have immediate implications for policy. Given that some countries have avoided increases in suicides despite significant economic downturns, there is a clear need to implement policy initiatives that promote the resilience of populations during the ongoing recession. Active labour market programmes—projects that immediately help the unemployed find social support and new work opportunities (even part time)—and mental health prevention programmes seem to mitigate significantly the negative mental health effects of recessions.