Real-time monitoring studies of suicidal thoughts and behaviors (STB) often include follow-up engagements activated by high-risk alerts, addressing ethical obligations. However, the direct impact of continuous monitoring on STB outcomes remains an under-investigated area. This impact could stem from two core aspects of real-time monitoring: a) detailed self-observation of STB, including emotional and situational factors, promoting emotional awareness and insight, and b) professional oversight of critical alerts, fostering a sense of connection. Both emotional insight and connectedness may in turn mitigate STB. Our observational study on real-time monitoring among high-risk adolescents included 86 high-risk suicidal adolescents aged 11-18. Participants completed weekly self-assessment surveys on STB and underwent constant passive digital monitoring alongside their regular mental health services. We compared STB outcomes at 1- and 6-month follow-ups between the digital monitoring group (n=86) and the standard care group receiving usual treatment (TAU) (n=281). Significant reductions in suicidal thoughts, suicide attempts, and non-suicidal self-injury (NSSI) within the digital monitoring group were found at both the 1 and 6-month evaluations, with effect size estimates suggesting moderate to strong effects [1-month ideation: [Wald=7.15, p<0.01]; behaviors [Wald=12.44, p<.001], NSSI [Wald=5.93, p=0.01]; 6-month ideation [Wald=4.06, p=0.04], behaviors [Wald=11.48, p<.001], NSSI [Wald=9.94, p<.001]. Verbal feedback themes involved increased emotional awareness ("It helped me see how I'm doing relative to myself and track my feelings") and enhanced connectedness ("Feeling like someone cared, checking in on me"). Our findings illuminate the protective potential of real-time digital monitoring against STB, presenting a promising strategy for managing and supporting high-risk adolescents, particularly in clinical environments with resource constraints.