The Role of Perceived Hyper-Surveillance in Adolescent Suicide Risk

Adolescent suicide is a worsening public health crisis. Amid rising authoritarian policies that disproportionately target minoritized youth, the psychological costs of hyper-surveillance (targeted, punitive monitoring) remain unexamined. This study provides an initial operationalization of perceived hyper-surveillance to examine its relationship with suicide ideation (SI) severity, suicide attempts, and antisocial behavior, beyond the effects of discrimination and violence exposure.

In a cross-sectional study of 476 adolescents (13-17 years; 63% Black; 55% male-identifying) recruited online and in community settings. Hyper-surveillance was operationalized using items from validated measures that captured experiences across community and school settings. Multivariable regression models tested associations between traumatic-stress symptoms, hyper-surveillance, SI severity, suicide attempts, and antisocial behavior. Thematic analysis explored how adolescents believed hyper-surveillance contributed to suicide risk.

Traumatic-stress symptoms and hyper-surveillance were independently associated with increased SI severity and suicide attempts (ps < .001). Hyper-surveillance moderated associations between traumatic-stress symptoms and both SI severity and antisocial behavior. Those with darker skin tones experienced disproportionately more hyper-surveillance independent of antisocial behavior. Over half (58.3%) of adolescents with SI reported that hyper-surveillance contributed to their desire to die; qualitative themes reflected negative affect and beliefs about themselves, others, and the world.

Amid expanding surveillance infrastructure in schools and communities (with known disparities in how these systems operate), these findings provide initial evidence that perceived hyper-surveillance functions as a modifiable risk factor for youth suicide. Clinical assessment of punitive surveillance experiences should be integrated into suicide risk evaluation for adolescents.