Personal Internalization of a Confederate Monument Removal Event Associated with Increased Depression, Anxiety, and Stress Among University Students

Abstract

This study sought to determine the association between racialized events relating to the removal of a Confederate monument and mental health outcomes among students at a Southern state-university in the United States. After the removal of a Confederate monument located on the university’s campus, racialized protests and violent clashes with police forces ensued. To assess the impact of these events on student mental health outcomes, a cross-sectional survey was disseminated to 10,000 current students. Student mental health was measured using the 21-item Depression, Anxiety, and Stress Scale (DASS). The key exposure, personal internalization of the event, was measured using the seven-question Centrality of Event Scale (CES) and was defined as the perceived importance of the racialized event for the students’ identity and life story. Student demographic information including race, ethnicity, gender, age, and minority status was collected anonymously. Logistic regression was used to compare mental health outcomes of students with high versus low personal internalization of the event, with an interaction term included to capture if the relationship was stronger among students who identified as a minority. After adjusting for minority status, higher internalization of the event was associated with adverse mental health outcomes (OR = 1.96 [95%CI, 1.18-3.25]). However, there was insufficient evidence to determine that minority status modified the results, which may be due to limited power. Overall, these findings demonstrate that increased internalization of the removal event was associated with adverse mental health outcomes among students during the first two weeks of the academic semester, underscoring the importance of state and university official’s consideration of the mental health implications of racial tensions arising from Confederate monument removal events for diverse student populations and strategies for mitigating these outcomes.