Does only spending what you make lead to suicide? In the world of weak observational studies, it can. Suicides in Greece reached a 30 year all-time high in 2012, with a sustained upward trend starting in June 2011, the month that the government introduced austerity measures to get loans and help pay down the country's debts, currently at 175 percent of GDP and caused by overspending on social services. 

Writing in BMJ Open, scholars tracked the number of suicides recorded in Greece every month between January 1983 and December 2012 to correlation between austerity measures and suicides, using national death certification data from the Hellenic Statistical Authority. Data for later years were not available at the time of study. Because of large influxes of outside money into Greece, the 1997 announcement that Greece would host the 2004 Olympic Games, the country's admission into the European Union and adoption of the Euro in 2002, and the Olympic Games in 2004 were classified as prosperity events during this period.

Austerity events, all of which occurred between 2008 and 2012, began with the Greek recession in 2008, through a series of financial bail-out packages, riots, strikes and protests, and the public suicide of a Greek pensioner in the main square of Athens in response to austerity conditions. Between 1983 and 2012, 11,505 people took their own lives: 9,079 men and 2,426 women.

The introduction of austerity measures in June 2011 marked the start of a significant, sharp, and sustained increase in suicides, to reach a peak in 2012, the figures showed. The number of total suicides rose by over 35% in June 2011, which was sustained for the rest of the year and into 2012, equivalent to an extra 11.2 suicides every month, on average. No other prosperity or austerity events over the 30 year period were associated with such a strong shift in the total number of suicides recorded.

The suicide rate in men started rising in 2008, when the Greek recession began, increasing by just over 13%, equivalent to an extra 3.2 suicides a month. The rate then rose by an additional 5.2 suicides every month (18.5%) from June 2011 onwards.

There was a further, but short-lived, rise in April 2012 of just under 30% (9.8 deaths a month), following a public suicide linked to austerity conditions. This was very widely covered in the news media and included a lot of detail and quotes from the suicide note--factors that may have prompted copycat suicides, say the researchers.

By contrast, the launch of the Euro in Greece in January 2002 marked an abrupt but short-lived fall of 27% fewer suicides among men. 

Economic instability in Greece has primarily affected men, who are still the main breadwinners, say the researchers, adding that the trends between 2008 and 2011 reveal the long term and systemic effects that large government austerity programmes can have on national economic stability and public health. Suicides among women, who accounted for one in four such deaths over the 30 years, also surged by an extra 2.4 a month (just under 36%) in May 2011 following events associated with austerity, an increase that was sustained in 2012.

Further analyses, which included adjustments for potential undercounting of suicide (for religious and other reasons), showed the same sustained increased in June 2011. This further reinforces the importance of the events during this month, say the researchers.  

June 2011 marked the beginning of the first part of a larger austerity plan that was narrowly voted through amidst widespread public opposition, manifest in violent protests and strikes.

"Despite historically having one of the lowest suicide rates in the world, Greece is thought to have been more affected by the global financial downturn than any other European country," write the researchers.

High unemployment, household debt, comprehensive welfare and benefit cuts, and increasing homelessness prompted by the unrelenting and sizable economic downturn in Greece are likely to have piled on the stress and created a sense of hopelessness, they say.

"As future austerity measures are considered, greater weight should be given to unintended health consequences of these measures," they write, adding: "Greater attention should also be paid to the public reporting of austerity measures and any subsequent suicide-related events that may follow."