This study examined the psychosocial and psychiatric features of 16 Japanese suicide completers with unmanageable debt compared with 23 suicide completers without such debt at time of death, using a psychological autopsy method. The individuals with unmanageable debt were more likely to have been self-employed and to have experienced divorce. They were less likely to have engaged in help-seeking behavior, despite having mental health problems. Our findings suggest that providing comprehensive support and promoting help-seeking behavior may be important for suicide prevention in middle-aged men.