Suicides in Greece rose sharply and remained high after the introduction of recent cost-cutting austerity measures, according to a study released today. The findings, based on reported suicides over a 30-year period, add to growing concerns about the immediate health impacts of major public spending cuts passed across Europe following the global financial crisis.

The study, published in the BMJ Open, examines trends in monthly suicides in Greece from 1983 to 2012. Its authors monitored monthly suicide totals changed following 12 pre-selected economic events: eight austerity-related and four prosperity-related. In October 2008, as Greece entered a recession, suicides among men spiked by 13 percent and maintained a higher average in the months that followed, the study reports. In June 2011, when a new round of austerity measures was met with protests and strikes, suicides among both men and women increased by 36 percent, and they remained high.

"It might be the economic policies themselves that are driving it, but also the public messaging."

Suicide rates in Greece and much of southern Europe have historically been low compared to other developed countries. But a 2011 study found that rates have increased across Europe following the financial crisis, especially in debt-saddled Greece. In 2010, the Greek government began rolling out a series of controversial measures that would raise taxes and cut billions in public spending, sparking widespread protests and general strikes. The cost-cutting also left its public healthcare system under considerable strain, prompting closer studies of its health-related impacts. A 2014 study found a direct link between spending cuts and increased suicide rates among Greek men, while a 2013 paper found a similar connection in Spain following the financial crisis. Others have expressed more skepticism about the relationship between Greece’s economic crisis and elevated suicides. The study released today is the first to link monthly suicide data over multiple decades to specific austerity-related events, though its authors are quick to note that their findings shouldn’t be interpreted as a policy critique.

"We are not economists or finance ministers or bankers, so we don’t have any comment about the actual austerity measures and what’s in them and how they’re constructed," says Charles Branas, an epidemiologist at the University of Pennsylvania and lead author of the study. "However… I think perhaps policy makers can understand there are potentially negative public health impacts that follow austerity measures like this — perhaps very soon after austerity measures. It might be the economic policies themselves that are driving it, but also the public messaging of the policies."

Education and prevention are critical, though the media may have a role to play as well, Branas says. According to his analysis, male suicides briefly jumped by 30 percent after a Greek pensioner publicly committed suicide in April 2012. The event received widespread coverage and, as the study notes, was reported in ways that could promote copycats: details of the man’s life, his method of suicide, and quotes from a note he left behind. Interestingly, one prosperity-related event — the adoption of the euro currency in January 2002 — preceded a sharp but temporary 27 percent decrease in male suicides.

"we cannot close our eyes to what is obvious."

Branas stresses that his study examines only the short-term impact of austerity-related events on suicides and that it excludes data on attempted suicides. The authors controlled for changes in population, demographics, unemployment, and other variables, though they acknowledge that the difficulty in isolating the impact of a single event. The pensioner’s public suicide, for example, happened during the same month as the announcement of national elections, heightening political and economic tensions.

Thomas Hyphantis, a psychiatry professor at Greece’s University of Ioannina, who was not involved in the study, says Branas’ work "confirms without doubt" that the Greek crisis has had a detrimental impact on suicides.

"It is true that not all suicides are due to the financial crisis and austerity measures, and this should be seriously taken into account, especially by the media when presenting individual suicides or suicide rates," Hyphantis said in an email. "However, it is also true that not all suicides have their origins in the individual’s biological or psychological background, and the research at hand has established the link between suicide rates and austerity measures taken in Greece. We cannot therefore push this message ‘under the pillow’; we cannot close our eyes to what is obvious."

Others raise doubts that the announcement of austerity measures would have such an immediate impact on suicide rates. "Of course, suicide is not an option that [somebody] takes in a couple of days or months," says Nikolaos Antonakakis, an economics professor at Vienna University for Economics and Business, who was not involved with the study. Antonakakis, who co-authored the 2014 study linking spending cuts to increased male suicides, adds that the model used in today’s study could be extended to examine longer periods before and after austerity measures are announced. This, he says, would give a better sense of the mechanisms through which the policies may lead to increased suicide rates. "If they’re applied immediately, and lead to immediate pension cuts, then of course the effect on suicide will be more immediate," he says. "But it also takes some time" for their full economic effect to be felt.

Experts agree that Greece’s suicide trends are worrisome, and its economic outlook remains grim. But its politics have suddenly changed. Last month, the left-wing Syriza party swept into power. Their first order of action: rolling back austerity.