The Role of Perceived Hyper-Surveillance in Adolescent Suicide Risk

OBJECTIVE: 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. METHOD: 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. RESULTS: 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. CONCLUSION: 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.