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Objectives. To quantify deaths in the United States from 2010 through 2018 that were reported with an underlying cause of death as a psychiatric diagnosis, which do not indicate a clear mechanism of death, and that may be misclassified suicide and overdose deaths. Methods. We used national vital statistics data to identify rates and circumstances of deaths by specific underlying cause of death categories in the US population. Results. There were 115 442 deaths attributed to psychiatric diagnoses and 834 763 deaths attributed to suicide or overdose. The population rate of deaths attributed to psychiatric diagnoses increased from 3.26 to 4.96 per 100 000 US persons between 2010 and 2018. Conclusions. Psychiatric diagnoses may represent a fairly substantial number of misclassified overdose and suicide deaths. Improving mortality surveillance requires improving the accuracy of diagnoses reported on death certificates.