From the mid-1990s on, the suicide rate in Italy declined steadily, then apparently rising again after the onset of the Great Recession, along with a sharp increase in unemployment. The aim of this study is to test the association between the suicide rate and unemployment (i.e., the unemployment rate for males and females in the period 1977-2015 and the long-term unemployment rate in the period 1983-2012) in Italy, by means of co-integration techniques. The analysis was adjusted for public unemployment spending (referring to the period 1980-2012). The study identified a long-run relationship between the suicide rate and long-term unemployment. On the other hand, an association between the suicide and unemployment rate stemmed out, though statistically weaker. A 1% increase in long-term unemployment increases the suicide rate by 0.83%, with a long-term effect lasting up to eighteen years. Public unemployment spending (as percentage of the Italian Gross Domestic Product) may mitigate this association: when its annual growth rate is higher than 0.18%, no impact of unemployment on suicide in detectable. A decrease in the suicide rate is expected for higher amounts of social spending, which may be able to compensate for the reduced level of social integration resulting from unemployment, helping the individual to continue to integrate into society. A corollary of this is that austerity in times of economic recession may exacerbate the impact of the economic downturn on mental health. However, a specific ''flexicurity'' system (intended as a combination of high employment protection, job satisfaction and labour-market policies) may have a positive impact on health. 2001 [25], while Stuckler et al. collected data referring to mortality in 1970-2003 (including 2006) [12]. Our intention was to fill this gap, by extending the analysis, thus including the Great Recession and the subsequent years of severe economic crisis, as well as data concerning social protection measures. Methods Data collection From the Organisation for Economic Cooperation and Development (OECD) Statistics (https://data.oecd.org/) we extracted the following data for Italy: male and female suicide rates (for the period 1977-2015), male and female unemployment rates (1977-2015), long-term unemployment rate (1983-2012), public unemployment spending expressed as a percentage of Gross Domestic Product (GDP) (1980-2012). According to the OECD, "Long-term unemployment refers to people who have been unemployed for 12 months or more. The long-term unemployment rate shows the proportion of these long-term unemployed among all unemployed." [34] On the other hand, "Public unemployment spending is defined as expenditure on cash benefits for people to compensate for unemployment. This includes redundancy payments from public funds, as well as the payment of pensions to beneficiaries before they reach the standard pensionable age, if these payments are made because the beneficiaries are out of work or for other labour market policy reasons. This indicator is measure...