Suicide rates for adults between 40 and 64 years of age in the U.S. have risen about 40% since 1999, with a sharp rise since 2007. One possible explanation could be the detrimental effects of the economic downturn of 2007-2009, leading to disproportionate effects on house values, household finances, and retirement savings for that age group. In a study published in the American Journal of Preventive Medicine, researchers found that external economic factors were present in 37.5% of all completed suicides in 2010, rising from 32.9% in 2005.

In addition, suffocation, a method more likely to be used in suicides related to job, economic, or legal factors, increased disproportionately among the middle-aged. The number of suicides using suffocation increased 59.5% among those aged 40-64 years between 2005 and 2010, compared with 18.0% for those aged 15-39 years and 27.2% for aged >65 years.

"Relative to other age groups, a larger and increasing proportion of middle-aged suicides have circumstances associated with job, financial, or legal distress and are completed using suffocation," noted study authors Katherine A. Hempstead, PhD, Director of the Robert Wood Johnson Foundation, Princeton, NJ, and the Center for State Health Policy at Rutgers University, and Julie A. Phillips, PhD, Institute for Health, Health Care Policy and Aging Research, New Brunswick, NJ. "The sharpest increase in external circumstances appears to be temporally related to the worst years of the Great Recession, consistent with other work showing a link between deteriorating economic conditions and suicide. External circumstances also have increased in importance among those aged ?65 years. Financial difficulties related to the loss of retirement savings in the stock market crash may explain some of this trend."

Using data from the National Violent Death Reporting System (NVDRS), which links information on violent deaths from multiple sources including medical examiner and coroner reports, toxicology reports, law enforcement records, supplemental homicide reports, and death certificates, researchers were able to analyze 17 distinct suicide circumstances and four indicators related to planning and intent.

The suicide circumstances were grouped into three major categories: personal, interpersonal, and external. Examples of personal circumstances are depressed mood, current treatment for a mental health problem, or alcohol dependence. Interpersonal circumstances include an intimate partner problem, the death of a friend, or being a victim of intimate partner violence. Examples of external circumstances are a job or financial problem, legal problem, or difficulty in school.

The four planning and intent factors are crisis in the past two weeks, leaving a suicide note, disclosing an intent to commit suicide, or a history of prior attempts.

The authors caution that "increased awareness is needed that job loss, bankruptcy, foreclosure, and other financial setbacks can be risk factors for suicide. Human resource departments, employee assistance programs, state and local employment agencies, credit counselors, and others who interact with those in financial distress should improve their ability to recognize people at risk and make referrals. Increasing access to crisis counseling and other mental health services on an emergency basis, as is often provided at times of natural disaster, should also be considered in the context of economic crises."