Hyper-surveillance and suicides among Black youth in the U.S.

Ohio State University, Columbus OH

Investigators

Abstract

Project Summary/Abstract Suicide rates among Black youth have risen markedly in recent decades, now exceeding those among White youth by over 60%. Black youth also exhibit the highest rates of Emergency Department (ED) visits for suicidal ideation and self-harm compared to all other racial and ethnic groups. While the causes of these concerning trends are likely multifactorial, there is increasing interest in examining how broader structural and environmental factors may contribute to mental health risk among youth. One such factor is hyper-surveillance, defined as intensive monitoring and engagement by law enforcement, including frequent or intrusive police stops. Research has identified police contact as a potential social determinant of youth mental health, with evidence linking such contact to increased psychological distress, anxiety, depression, and trauma-related symptoms. However, there remains a significant gap in understanding the potential relationship between law enforcement practices and suicide-related outcomes. To address this gap in research, we propose to examine the relation between police stops and (i) ED visits for suicidal ideation/self-harm and (ii) suicide mortality among youth (outcomes). We propose a multi-state, county-level examination of the relation between police stops and suicide-related outcomes (ED visits for suicidal ideation/self-harm, suicides) across 10 US states (AZ, FL, KS, MA, MN, NC, NJ, NY, SC, WI), from 2006 to 2019 using national, high-quality datasets and advanced econometric methods. We will also leverage the unique case of the New York Police Department's (NYPD) stop, question, and frisk (SQF) policy as a natural experiment towards causal examination of the ecological relation between the rate and volume of police stops and suicide-related outcomes among youth in New York City (NYC). In 2013, a federal court ruled NYPD’s SQF policy unconstitutional (Floyd, et al. v. City of New York, et al., 2013), and the number of stop-and-frisks conducted by NYPD declined sharply. We will use this ruling as a natural experiment to examine whether reductions in hyper-surveillance are associated with changes in suicide-related outcomes among youth in New York City. We will retrieve data on police stops for 10 US states from the Stanford Open Policing Database, and New York City-specific police stops data from the New York Civil Liberties Union's stop-and-frisk database. Suicide mortality by region and sociodemographic factors will be obtained from the National Center for Health Statistics mortality database. We will acquire ED visits data (by ICD9/10 diagnosis code, county, month, year, sociodemographics) from the State Emergency Department Database (SEDD) and the State Inpatient Database (SID). We will formulate our exposures as the rate and volume of police stops (per 100,000 population). We will conduct empirical analyses using (1) two-way fixed effects, (2) time series, (3) difference-in-difference, and (4) synthetic control methods to examine the spatio-temporal relation between our outcomes and exposures. Our study will rigorously examine the ecological relation between police stops and suicide-related outcomes among youth. Findings from our study may inform policy-relevant interventions for suicide prevention.