The Unfalsifiable Delusion: How Mass Surveillance Infrastructure Creates Disparate Impact on People with Paranoia-Spectrum Conditions

Reality testing is a core cognitive-behavioral intervention for persecutory delusions: the clinician helps the patient examine evidence for the belief that they are being monitored, the patient discovers the belief is unfounded, and cognitive reframing occurs. This paper argues that mass surveillance infrastructure deployed by U.S. government agencies and their private contractors has eliminated the foundational precondition for this intervention by making persecutory beliefs factually accurate for the general population, creating a specific and documentable disparate impact on Americans with paranoia-spectrum conditions. We identify three distinct mechanisms of harm: reality testing destruction, in which the therapeutic intervention fails because the environment has changed to confirm the delusion rather than because the patient resists treatment; device abandonment and social isolation, in which affected individuals make the rational decision to discard communication devices upon learning that government geofencing captures every phone in their neighborhood, severing contact with support systems and crisis services; and algorithmic pattern-matching discrimination, in which surveillance systems designed to flag anomalous movement patterns systematically misidentify the behavioral symptoms of paranoia-spectrum conditions as suspicious activity, subjecting affected individuals to additional scrutiny that compounds the original harm. We document that this intersection has been entirely overlooked in both the surveillance policy literature and the clinical psychiatric literature, including a 119-page European Parliament analysis on AI surveillance and human rights that does not contain the word "disability." We frame these harms under ADA Title II and Section 504, identify a novel legal problem we term the self-sealing paradox (in which surveillance retroactively eliminates the diagnostic category it damages), and propose clinical, legal, and policy responses.