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Background The coronavirus disease (COVID-19) pandemic is an unprecedented public health crisis, but its effect on suicide deaths is little understood. Methods We analyzed data from monthly suicide statistics between January 2017 and October 2020 and from online surveys on mental health filled out by the general population in Japan. Results Compared to the 2017–19 period, the number of suicide deaths during the initial phase of the pandemic was lower than average but exceeded the past trend from July 2020. Female suicides, whose numbers increased by approximately 70% in October 2020 (incidence rate ratio: 1.695, 95% confidence interval: 1.558–1.843), were the main source of this increase. The largest increase was found among young women (less than 40 years of age). Our survey data indicated that the status of young women’s mental health has been deteriorating in recent months and that young female workers were more likely to have experienced a job or income loss than any other group, suggesting adverse economic conditions surrounding them. Conclusions Continuous monitoring of mental health, particularly that of the most vulnerable populations identified in this study, and appropriate suicide prevention efforts are necessary during the COVID-19 pandemic.

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