The number of suicides related to unemployment remains stubbornly high despite the improving economy, according to a study published this week.

Researchers had previously registered a spike in suicides during the global economic crisis that began in 2008, suggesting that financial stress and hardship had contributed to the rise. But an analysis published on Tuesday in The Lancet Psychiatry by doctors at the University of Zurich in Switzerland estimates that about 5,000 suicides were associated with the crisis, while roughly nine times as many self-inflicted deaths are linked to unemployment each year.

The psychiatrists analyzed the suicide rates and economic statistics of 63 countries from 2000 to 2011 and determined that unemployment is connected to approximately 45,000 suicides annually. According to their findings, unemployment elevated the relative risk of suicide by 20 to 30 percent throughout the world. Suicides related to unemployment accounted for about a fifth of annual totals worldwide, and the association was strongest in countries where being out of work is uncommon.

"It is possible that an unexpected increase in the unemployment rate may trigger greater fears and insecurity than in countries with higher pre-crisis unemployment levels," Carlos Nordt, the lead author of the study, said.

Though the financial outlook has improved since 2008, suicides tied to unemployment are likely to remain high. The authors noted that prevention efforts should focus on addressing unemployment and its effects in stable times as well as difficult ones.

Dan Reidenberg, director of the group Suicide Awareness Voices of Education and managing director of the National Council for Suicide Prevention, told VICE News that fear of loss can play a significant role in suicide. Those who are unemployed can fear losing their income, healthcare, homes, and retirement savings, and doubt their ability to provide for their families.

"Employment is tied to identity," he said. "When people lose a sense of identity and purpose it becomes problematic for them. For someone who is particularly vulnerable or at risk, if you add on a loss of sense of purpose, the risk goes up."

John Draper, the director of the National Suicide Prevention Lifeline, told VICE News that the risks are particularly acute for working-age men, noting that upwards of 80 percent of those who kill themselves are men, most of whom are between the ages of 25 and 64.

"Men are notoriously bad at help-seeking, and their lack of self-care and accepting and taking support from others can cost them their lives," Draper said.

But he cautioned against blaming suicides generally on unemployment, noting that several factors usually affect people to the point that they will consider ending their lives.

"What we see with unemployment is that it increases the risk because it makes already bad situations worse for some people," he said. "Any kind of economic strain or unemployment, to the degree that there are already mental health or substance abuse or relationship problems, can make it worse."

Reidenberg discussed the vulnerability of baby boomers who face other risk factors associated with aging.

"As the baby boom population is moving into a high-age category, it's more than just unemployment," he said. "Unemployment is a major contributing factor to suicide risk, as are other things as they age: physical issues, lack of income, loss of home or retirement. Those continue to be problematic for them, far longer than their unemployment situations."

Of course, not all unemployed individuals are suicide risks. Those who have overcome difficult situations in the past might prove more resilient when dealing with the fear and anxiety that can accompany the loss of a job. At the same time, individuals might face heightened risk due to various problems arising at once.

"If you lose your job, you may be able to bounce back, but if your spouse leaves you or your kids are struggling in school, or your parent passes or becomes ill and you're responsible for them, it's that multiple level of stress," Reidenberg said. "No matter the resiliency in the first example, that multiple stress level is when we see the increased risk."

Policies to help prevent unemployment-related suicides could include instructing companies on how to better prepare employees for layoffs, helping the unemployed find work, and improving access to mental and behavioral health services.

"We need to make companies understand how to protect employees before leaving, to build up their skillsets, to look at different alternatives besides just layoffs and longer coverage for insurance," Reidenberg suggested. "This might be economically challenging for companies, but the reality is the cost to an employee of losing their job could be their life."

Draper believes that public awareness campaigns regarding men's health should focus on eliminating the stigma of seeking assistance.

"It takes strong and smart person to say this is above my ability to deal with on my own, I've got to get help," he said, noting that most countries have national suicide hotlines where people can turn for help in alleviating emotional distress and suicidal thoughts.

In the United States, that number is 1-800-273-8255.