Since the 1950s, the suicide rate in the United States has been significantly higher among men than women. In 2022, the suicide rate among men was almost four times higher than that of women. However, the rate of suicide for both men and women has increased gradually over the past couple of decades. Facts on suicide in the United States In 2022, the rate of suicide death in the United States was around 14 per 100,000 population. The suicide rate in the U.S. has generally increased since the year 2000, with the highest rates ever recorded in the years 2018 and 2022. In the United States, death rates from suicide are highest among those aged 45 to 64 years and lowest among younger adults aged 15 to 24. The states with the highest rates of suicide are Montana, Alaska, and Wyoming, while New Jersey and Massachusetts have the lowest rates. Suicide among men In 2023, around 4.5 percent of men in the United States reported having serious thoughts of suicide in the past year. Although this rate is lower than that of women, men still have a higher rate of suicide death than women. One reason for this may have to do with the method of suicide. Although firearms account for the largest share of suicide deaths among both men and women, firearms account for almost 60 percent of all suicides among men and just 35 percent among women. Suffocation and poisoning are the other most common methods of suicide among women, with the chances of surviving a suicide attempt from these methods being much higher than surviving an attempt by firearm. The age group with the highest rate of suicide death among men is by far those aged 75 years and over.

According to the latest available data, there were around 14.2 suicide deaths per 100,000 population in the United States in 2022. Suicide remains one of the leading causes of death in the U.S. highlighting the need for awareness and prevention. The suicide rate in the U.S. has risen for both men and women in recent years but remains over three times higher for men. Hospitalizations In 2021, there were around 517,000 adults hospitalized in the U.S. after a suicide attempt. Although the suicide rate among men is significantly higher than among women, there are more hospitalizations after suicide attempts for women than for men. In 2019, there were 288,000 such hospitalizations among women and 238,000 hospitalizations among men. Public opinionSuicide can be a divisive topic that involves religious and political views. Recent data shows that 72 percent of the U.S. population believes suicide is morally wrong, while 22 percent believe it to be morally acceptable. However, only 32 percent of adults believe it is “very important” to invest public dollars in the prevention of suicide.

Among men in the United States, those aged 75 years and older have the highest death rate from suicide among all age groups. In 2022, the suicide death rate among men aged 75 years and older was 43.9 per 100,000 population. In comparison, the death rate from suicide among men aged 25 to 44 years was 29.6 per 100,000. Suicide is a significant problem in the United States, with rates increasing over the past decade. Suicide among men In the United States, the suicide rate among men is almost four times higher than that of women. In 2022, the rate of suicide among U.S. men was 23 per 100,000 population, the highest rate recorded over the past 70 years. Firearms account for the vast majority of suicide deaths among men, accounting for around 60 percent of male suicides in 2021. The reasons why U.S. men have higher rates of suicide than women are complex and not fully understood, but may have to do with the more violent means by which men carry out suicide and the stigma around seeking help for mental health issues. Suicide among women Although the suicide rate among women in the U.S. is significantly lower than that of men, the rate of suicide among women has increased over the past couple of decades. Among women, those aged 45 to 64 years have the highest death rates due to suicide, followed by women 25 to 44 years old. Interestingly, the share of women reporting serious thoughts of suicide in the past year is higher than that of men, with around 5.5 percent of U.S. women reporting such thoughts in 2023. Similarly to men, firearms account for most suicide deaths among women, however suffocation and poisoning account for a significant share of suicides among women. In 2021, around 35 percent of suicides among women were carried out by firearms, while suffocation and poisoning each accounted for around 28 percent of suicide deaths.

The suicide rate among females in the United States is highest for those aged 45 to 64 years and lowest among girls aged 10 to 14 and elderly women 75 and over. Although the suicide rate among women remains over three times lower than that of men, rates of suicide among women have gradually increased over the past couple decades. Suicide among women in the United States In 2021, there were around six suicide deaths per 100,000 women in the United States. In comparison, the rate of suicide among women in the year 2000 was about four per 100,000. Suicide rates among women are by far the highest among American Indians or Alaska Natives and lowest among Hispanic and Black or African American women. Although firearms are involved in the highest share of suicide deaths among both men and women, they account for a much smaller share among women. In 2020, the firearm suicide rate among women was 1.8 per 100,000 population, while the rates of suicide for suffocation and poisoning were 1.7 and 1.5 per 100,000, respectively. Suicidal ideation among women Although not everyone who experiences suicidal ideation, or suicidal thoughts, will attempt suicide, suicidal thoughts are a risk factor for suicide. In 2022, just over five percent of women in the United States reported having serious thoughts of suicide in the past year. Suicidal thoughts are more common among women than men even though men have much higher rates of death from suicide than women. This is because men are more likely to use more lethal methods of suicide such as firearms. Women who suffer from substance use disorder are significantly more likely to have serious thoughts of suicide than women without substance use disorder.

Age-adjusted rate of suicide deaths for Santa Clara County residents. The data are provided for the total county population and by sex and race/ethnicity. Data trends are presented from 2007 to 2016. Source: Santa Clara County Public Health Department, VRBIS, 2007-2016. Data as of 05/26/2017; U.S. Census Bureau, 2010 Census.METADATA:Notes (String): Lists table title, notes and sourceYear (String): Year of death Category (String): Lists the category representing the data: Santa Clara County is for total population, sex: Male and Female, race/ethnicity: African American, Asian/Pacific Islander, Latino and White (non-Hispanic White only) and Asian/Pacific Islander subgroups: Asian Indian, Chinese. Filipino, Korean and Vietnamese.Age adjusted rate per 100,000 people (Numeric): The Tenth Revision of the International Classification of Diseases codes (ICD-10) are used for coding causes of death. Age-adjusted rate is calculated using 2000 U.S. Standard Population. Suicide rate is number of suicide deaths in a year per 100,000 people in the same time period.

This dataset presents the age-adjusted death rates for the 10 leading causes of death in the United States beginning in 1999. Data are based on information from all resident death certificates filed in the 50 states and the District of Columbia using demographic and medical characteristics. Age-adjusted death rates (per 100,000 population) are based on the 2000 U.S. standard population. Populations used for computing death rates after 2010 are postcensal estimates based on the 2010 census, estimated as of July 1, 2010. Rates for census years are based on populations enumerated in the corresponding censuses. Rates for non-census years before 2010 are revised using updated intercensal population estimates and may differ from rates previously published. Causes of death classified by the International Classification of Diseases, Tenth Revision (ICD–10) are ranked according to the number of deaths assigned to rankable causes. Cause of death statistics are based on the underlying cause of death. SOURCES CDC/NCHS, National Vital Statistics System, mortality data (see http://www.cdc.gov/nchs/deaths.htm); and CDC WONDER (see http://wonder.cdc.gov). REFERENCES National Center for Health Statistics. Vital statistics data available. Mortality multiple cause files. Hyattsville, MD: National Center for Health Statistics. Available from: https://www.cdc.gov/nchs/data_access/vitalstatsonline.htm. Murphy SL, Xu JQ, Kochanek KD, Curtin SC, and Arias E. Deaths: Final data for 2015. National vital statistics reports; vol 66. no. 6. Hyattsville, MD: National Center for Health Statistics. 2017. Available from: https://www.cdc.gov/nchs/data/nvsr/nvsr66/nvsr66_06.pdf.

The countries with the highest suicide mortality rate worldwide in 2019 included Lesotho, Guyana, and Eswatini. Suicide rates of men are much higher than among women in many countries. Lithuania has one of the highest suicide rates for men as of 2019, while South Korea reports the highest suicide rate for women.

In the United States

Although the United States is not among the countries with the highest suicide mortality rate, suicide is still one of the leading causes of death in the U.S. As with other countries, the suicide rate among males in the U.S. is much higher than among females. The age group with the highest rate of suicide is those aged 45 to 64 years, followed by 25 to 44-year-olds. The states with the highest suicide rates are Wyoming, Alaska, and Montana.

Risk factors and help

Major risk factors for suicide include mental health issues and substance abuse problems; however, it can be difficult to predict who is at risk. Warning signs such as talking about wanting to die, expressing feelings of depression, suicidal ideation, and abusing drugs or alcohol should be taken seriously and help should be sought as soon as possible. Suicide hotlines exist in many countries around the world and one should not hesitate to discuss such issues and feelings with a health care provider.

The leading causes of death by sex and ethnicity in New York City in since 2007. Cause of death is derived from the NYC death certificate which is issued for every death that occurs in New York City.

Report last ran: 09/24/2019
Rates based on small numbers (RSE > 30) as well as aggregate counts less than 5 have been suppressed in downloaded data

Source: Bureau of Vital Statistics and New York City Department of Health and Mental Hygiene

This dataset describes drug poisoning deaths at the U.S. and state level by selected demographic characteristics, and includes age-adjusted death rates for drug poisoning.

Deaths are classified using the International Classification of Diseases, Tenth Revision (ICD–10). Drug-poisoning deaths are defined as having ICD–10 underlying cause-of-death codes X40–X44 (unintentional), X60–X64 (suicide), X85 (homicide), or Y10–Y14 (undetermined intent).

Estimates are based on the National Vital Statistics System multiple cause-of-death mortality files (1). Age-adjusted death rates (deaths per 100,000 U.S. standard population for 2000) are calculated using the direct method. Populations used for computing death rates for 2011–2016 are postcensal estimates based on the 2010 U.S. census. Rates for census years are based on populations enumerated in the corresponding censuses. Rates for noncensus years before 2010 are revised using updated intercensal population estimates and may differ from rates previously published.

Death rates for some states and years may be low due to a high number of unresolved pending cases or misclassification of ICD–10 codes for unintentional poisoning as R99, “Other ill-defined and unspecified causes of mortality” (2). For example, this issue is known to affect New Jersey in 2009 and West Virginia in 2005 and 2009 but also may affect other years and other states. Drug poisoning death rates may be underestimated in those instances.

REFERENCES 1. National Center for Health Statistics. National Vital Statistics System: Mortality data. Available from: http://www.cdc.gov/nchs/deaths.htm.

1. CDC. CDC Wonder: Underlying cause of death 1999–2016. Available from: http://wonder.cdc.gov/wonder/help/ucd.html.

Rank, number of deaths, percentage of deaths, and age-specific mortality rates for the leading causes of death, by age group and sex, 2000 to most recent year.

This dataset contains counts of deaths for California as a whole based on information entered on death certificates. Final counts are derived from static data and include out-of-state deaths to California residents, whereas provisional counts are derived from incomplete and dynamic data. Provisional counts are based on the records available when the data was retrieved and may not represent all deaths that occurred during the time period. Deaths involving injuries from external or environmental forces, such as accidents, homicide and suicide, often require additional investigation that tends to delay certification of the cause and manner of death. This can result in significant under-reporting of these deaths in provisional data.

The final data tables include both deaths that occurred in California regardless of the place of residence (by occurrence) and deaths to California residents (by residence), whereas the provisional data table only includes deaths that occurred in California regardless of the place of residence (by occurrence). The data are reported as totals, as well as stratified by age, gender, race-ethnicity, and death place type. Deaths due to all causes (ALL) and selected underlying cause of death categories are provided. See temporal coverage for more information on which combinations are available for which years.

The cause of death categories are based solely on the underlying cause of death as coded by the International Classification of Diseases. The underlying cause of death is defined by the World Health Organization (WHO) as "the disease or injury which initiated the train of events leading directly to death, or the circumstances of the accident or violence which produced the fatal injury." It is a single value assigned to each death based on the details as entered on the death certificate. When more than one cause is listed, the order in which they are listed can affect which cause is coded as the underlying cause. This means that similar events could be coded with different underlying causes of death depending on variations in how they were entered. Consequently, while underlying cause of death provides a convenient comparison between cause of death categories, it may not capture the full impact of each cause of death as it does not always take into account all conditions contributing to the death.

This dataset describes injury mortality in the United States beginning in 1999. Two concepts are included in the circumstances of an injury death: intent of injury and mechanism of injury. Intent of injury describes whether the injury was inflicted purposefully (intentional injury) and, if purposeful, whether the injury was self-inflicted (suicide or self-harm) or inflicted by another person (homicide). Injuries that were not purposefully inflicted are considered unintentional (accidental) injuries. Mechanism of injury describes the source of the energy transfer that resulted in physical or physiological harm to the body. Examples of mechanisms of injury include falls, motor vehicle traffic crashes, burns, poisonings, and drownings (1,2). Data are based on information from all resident death certificates filed in the 50 states and the District of Columbia. Age-adjusted death rates (per 100,000 standard population) are based on the 2000 U.S. standard population. Populations used for computing death rates for 2011–2015 are postcensal estimates based on the 2010 census, estimated as of July 1, 2010. Rates for census years are based on populations enumerated in the corresponding censuses. Rates for non-census years before 2010 are revised using updated intercensal population estimates and may differ from rates previously published. Causes of injury death are classified by the International Classification of Diseases, Tenth Revision (ICD–10). Categories of injury intent and injury mechanism generally follow the categories in the external-cause-of-injury mortality matrix (1,2). Cause-of-death statistics are based on the underlying cause of death. SOURCES CDC/NCHS, National Vital Statistics System, mortality data (see http://www.cdc.gov/nchs/deaths.htm); and CDC WONDER (see http://wonder.cdc.gov). REFERENCES National Center for Health Statistics. ICD–10: External cause of injury mortality matrix. National Center for Health Statistics. Vital statistics data available. Mortality multiple cause files. Hyattsville, MD: National Center for Health Statistics. Available from: https://www.cdc.gov/nchs/data_access/vitalstatsonline.htm. Murphy SL, Xu JQ, Kochanek KD, Curtin SC, and Arias E. Deaths: Final data for 2015. National vital statistics reports; vol 66. no. 6. Hyattsville, MD: National Center for Health Statistics. 2017. Available from: https://www.cdc.gov/nchs/data/nvsr/nvsr66/nvsr66_06.pdf. Miniño AM, Anderson RN, Fingerhut LA, Boudreault MA, Warner M. Deaths: Injuries, 2002. National vital statistics reports; vol 54 no 10. Hyattsville, MD: National Center for Health Statistics. 2006.

This dataset contains model-based county estimates for drug-poisoning mortality.

Deaths are classified using the International Classification of Diseases, Tenth Revision (ICD–10). Drug-poisoning deaths are defined as having ICD–10 underlying cause-of-death codes X40–X44 (unintentional), X60–X64 (suicide), X85 (homicide), or Y10–Y14 (undetermined intent).

Estimates are based on the National Vital Statistics System multiple cause-of-death mortality files (1). Age-adjusted death rates (deaths per 100,000 U.S. standard population for 2000) are calculated using the direct method. Populations used for computing death rates for 2011–2016 are postcensal estimates based on the 2010 U.S. census. Rates for census years are based on populations enumerated in the corresponding censuses. Rates for noncensus years before 2010 are revised using updated intercensal population estimates and may differ from rates previously published.

Death rates for some states and years may be low due to a high number of unresolved pending cases or misclassification of ICD–10 codes for unintentional poisoning as R99, “Other ill-defined and unspecified causes of mortality” (2). For example, this issue is known to affect New Jersey in 2009 and West Virginia in 2005 and 2009 but also may affect other years and other states. Drug poisoning death rates may be underestimated in those instances.

Smoothed county age-adjusted death rates (deaths per 100,000 population) were obtained according to methods described elsewhere (3–5). Briefly, two-stage hierarchical models were used to generate empirical Bayes estimates of county age-adjusted death rates due to drug poisoning for each year. These annual county-level estimates “borrow strength” across counties to generate stable estimates of death rates where data are sparse due to small population size (3,5). Estimates for 1999-2015 have been updated, and may differ slightly from previously published estimates. Differences are expected to be minimal, and may result from different county boundaries used in this release (see below) and from the inclusion of an additional year of data. Previously published estimates can be found here for comparison.(6) Estimates are unavailable for Broomfield County, Colorado, and Denali County, Alaska, before 2003 (7,8). Additionally, Clifton Forge County, Virginia only appears on the mortality files prior to 2003, while Bedford City, Virginia was added to Bedford County in 2015 and no longer appears in the mortality file in 2015. These counties were therefore merged with adjacent counties where necessary to create a consistent set of geographic units across the time period. County boundaries are largely consistent with the vintage 2005-2007 bridged-race population file geographies, with the modifications noted previously (7,8).

REFERENCES
1. National Center for Health Statistics. National Vital Statistics System: Mortality data. Available from: http://www.cdc.gov/nchs/deaths.htm.

1. CDC. CDC Wonder: Underlying cause of death 1999–2016. Available from: http://wonder.cdc.gov/wonder/help/ucd.html.

2. Rossen LM, Khan D, Warner M. Trends and geographic patterns in drug-poisoning death rates in the U.S., 1999–2009. Am J Prev Med 45(6):e19–25. 2013.

3. Rossen LM, Khan D, Warner M. Hot spots in mortality from drug poisoning in the United States, 2007–2009. Health Place 26:14–20. 2014.

4. Rossen LM, Khan D, Hamilton B, Warner M. Spatiotemporal variation in selected health outcomes from the National Vital Statistics System. Presented at: 2015 National Conference on Health Statistics, August 25, 2015, Bethesda, MD. Available from: http://www.cdc.gov/nchs/ppt/nchs2015/Rossen_Tuesday_WhiteOak_BB3.pdf.

5. Rossen LM, Bastian B, Warner M, and Khan D. NCHS – Drug Poisoning Mortality by County: United States, 1999-2015. Available from: https://data.cdc.gov/NCHS/NCHS-Drug-Poisoning-Mortality-by-County-United....

6. National Center for Health Statistics. County geography changes: 1990–2012. Available from: http://www.cdc.gov/nchs/data/nvss/bridged_race/County_Geography_Changes.pdf.

7. National Center for Health Statistics. County geography changes: 1990–2015. Available from: https://www.cdc.gov/nchs/nvss/bridged_race/county_geography-_changes2015....

In 2021, the leading causes of death among veterans in the United States were heart disease, cancer, and COVID-19. Heart disease and cancer account for the majority of deaths among U.S. veterans, which is also true for people in the United States in general.

The leading causes of death among veterans vs the U.S. as a whole Although the leading causes of death for U.S. veterans are similar to the overall leading causes of death in the United States, there are some differences. For example, even though heart disease and cancer are the leading causes of death for the entire United States and veterans specifically, death rates for both heart disease and cancer are much higher among veterans. In 2021, the death rate for heart disease among veterans was 267 per 100,000 population, compared to an overall rate of 167 per 100,000 population for the United States in 2022. Another clear difference is that while suicide was the seventh leading cause of death among veterans in 2021, it was not even among the leading ten causes of death for the United States as a whole.

Suicide among veterans Given the stressful and often dangerous work of U.S. military personnel, the mental health of U.S. veterans remains a prevalent issue. In 2021, it was estimated that around 10 percent of U.S. veterans had serious thoughts of suicide in the past year, while three percent made suicide plans, and two percent attempted suicide. That year there were around 6,392 suicide deaths among veterans in the United States. Veterans suffering from substance use disorders or mental health conditions are much more likely to die from suicide than veterans who do not have such disorders.

In 2023, the 50 to 59-year age group had the highest suicide rate in Japan, with 23.4 suicides per 100,000 inhabitants. Middle-aged men are frequently portrayed as the highest-risk group for suicide in Japan. On the other hand, suicides among the elderly and schoolchildren are also recurrently picked up by the media. Japan's recent suicide rates Japan’s suicide numbers peaked in 2009 when the country experienced its worst recession since World War II. That same year, the suicide rate surged to 25.7 deaths per 100,000 inhabitants and almost 33 thousand victims in total. While the country's suicide rate has shown a steady downward trend in the most recent decade, 2020 marked the first time within the past decade that suicide numbers were rising again. The COVID-19 pandemic likely caused this upward trend.From a gender perspective, Japanese men are more likely to commit suicide than women. In 2023, 24.6 deaths per 100,000 male inhabitants were reported, compared to a female suicide rate of 10.9 in the same year.  What are the reasons behind Japan’s high suicide rates?  Many factors are being blamed for the Japan's high suicide rates, including financial anxiety, bullying, isolation, and a lack of a proficient mental healthcare system. Historically, the country's high suicide rates have been closely linked to the economic situation of the individuals. Existential worries and problems directly related to work have been one of the main reasons for self-inflicted deaths in the past years.In the past 10 years, one of the most profound issues faced by employees in Japan leading to self-harm was exhaustion. An increasing pressure of retaining jobs by putting in more hours of overtime, while taking fewer holidays and sick days, are considered the main motivators behind the rising suicide numbers among office workers and employees. Occupational sudden mortality, known as karoshi (“death by overwork”) is a well-known phenomenon in Japanese society. Besides physical pressure, mental stress from the workplace can cause karoshi. Suicide due to occupational stress or overwork is called karojisatsu (“overwork suicide”) in Japan.

In 2022, the most significant cause of death among men in the United States was heart disease, which contributed to 22.5 percent of deaths. COVID-19 was the third leading cause of death among U.S. men in both 2020 and 2021, and the fourth leading cause in 2022. This statistic shows the distribution of the 10 leading causes of death among men in the United States from 2020 to 2022.

Once described by US President Herbert Hoover as "a great social and economic experiment", we now know that Prohibition was ultimately a failure, that led to increased crime and violence and gave way to a new era of mafia and mob influence in the United States. On January 17, 1920, the Volstead Act came into effect and the manufacturing, transportation, importation and sale of alcohol became federally prohibited across the United States, and while consumption was not a federal offence, it was sometimes prohibited on a state level. Opposition to Prohibition remained strong throughout the 1920s, and the Great Depression (starting in 1929) led many to advocate for the sale and taxation of alcoholic beverages in order to ease the US' economic woes. One of the reasons why Franklin D. Roosevelt was elected in 1932 was due to his promise of ending Prohibition, which he did with the Ratification of the 21st Amendment on December 5, 1933.

Impact on homicide rate

In the two decades before Prohibition, the recorded homicide rate in the United States was growing gradually, although often fluctuating in the 1910s. When Prohibition came into effect, the homicide rate continued on it's previous trajectory, but without fluctuating. While homicides related to alcohol consumption may have declined, some historians speculate that the total number could have continued to rise due to the increase in criminal activity associated with the illegal alcohol trade. The homicide rate in the US reached it's highest figure in the final year of Prohibition, with 9.7 homicides per 100,000 people in 1933, before falling to roughly half of this rate over the next ten years (this decrease in the early 1940s was also facilitated by the draft for the Second World War).

Impact on suicide rate

Alcohol's contribution to suicide rates has been significant throughout history, however it is only through more recent studies that society is beginning to form a clearer picture of what the relationship between the two actually is. In the first half of the twentieth century, there was no record of alcohol's role in individual suicide cases, however there was a noticeable change in the US' suicide rate during the 1920s. Prior to Prohibition, the suicide rate had already fallen from over 16 deaths per 100,000 people in 1915 to 11.5 in 1919, however this decline has been attributed to the role played by the First World War, which saw millions enlist and contribute to the war effort (a similar decrease can be observed in the lead up to the Second World War). After an initial spike in 1921, the suicide rate in the US then increases gradually throughout the 1920s, spiking again following the Great Depression in 1929. It is unclear whether the reduction in the US suicide rate in the 1910s and 1920s can be attributed to Prohibition, or whether it should be attributed to a variety of socio-economic factors, however the changing figures does suggest some correlation when compared with other decades.

As of 2022, the third leading cause of death among teenagers aged 15 to 19 years in the United States was intentional self-harm or suicide, contributing around 17 percent of deaths among age group. The leading cause of death at that time was unintentional injuries, contributing to around 37.4 percent of deaths, while 21.8 percent of all deaths in this age group were due to assault or homicide. Cancer and heart disease, the overall leading causes of death in the United States, are also among the leading causes of death among U.S. teenagers. Adolescent suicide in the United States In 2021, around 22 percent of students in grades 9 to 12 reported that they had seriously considered attempting suicide in the past year. Female students were around twice as likely to report seriously considering suicide compared to male students. In 2022, Montana had the highest rate of suicides among U.S. teenagers with around 39 deaths per 100,000 teenagers, followed by South Dakota with a rate of 33 per 100,000. The states with the lowest death rates among adolescents are New York and New Jersey. Mental health treatment Suicidal thoughts are a clear symptom of mental health issues. Mental health issues are not rare among children and adolescents, and treatment for such issues has become increasingly accepted and accessible. In 2021, around 15 percent of boys and girls aged 5 to 17 years had received some form of mental health treatment in the past year. At that time, around 35 percent of youths aged 12 to 17 years in the United States who were receiving specialty mental health services were doing so because they had thought about killing themselves or had already tried to kill themselves.

In 2023, there were 884 male deaths from all causes per 100,000 inhabitants in the United States. This statistics shows the death rate for all causes in the U.S. from 1950 to 2023, sorted by gender.

In 2023, Japan reported 17.6 suicides per 100,000 inhabitants. The country's suicide rate had shown a steady downwards trend over the past decade but began to rise again in 2020. The unexpected upward trend is likely to be connected to the COVID-19 pandemic.  What are the reasons behind Japan’s high suicide rates?  Historically, Japan’s high suicide rates were closely linked to the economic situation of individuals. While the majority of suicides in Japan stemmed from health reasons, existential worries and problems directly related to work also accounted for thousands of self-inflicted deaths in the past years. The most profound issue faced by employees in Japan leading to self-harm in the past decade has been exhaustion. An increasing pressure of retaining jobs by putting in more hours of overtime, while taking fewer holidays and sick days, were considered the main motivators behind the rising suicide numbers among office workers and employees. Occupational sudden mortality, known as karoshi ("death by overwork") is a well-known phenomenon in Japanese society. Besides physical pressure, mental stress from the workplace can cause karoshi. Suicide due to occupational stress or overwork is called karojisatsu ("overwork suicide") in Japan.  Which demographic groups are affected?  While middle-aged men were frequently portrayed as the highest-risk group for suicide in Japan, suicides among elderly and school children were recurrently picked up by the media. Financial anxiety, bullying, isolation, and the lack of a proficient mental healthcare system were only some factors contributing to the country’s high suicide rates among all age groups.