{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T10:56:06Z","timestamp":1790592966690,"version":"4.1.0"},"reference-count":39,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100008710","name":"Dementia Australia Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008710","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Geriat Psychiatry"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>This study aimed to examine the patterns and predictors of health service use for people with dementia who self\u2010harmed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using a retrospective linked cohort of people who accessed health services in New South Wales, Australia between 2001 and 2015, we identified 154,811 people with dementia or mild cognitive disorder (the dementia cohort), 28,972 people who self\u2010harmed (the self\u2010harm cohort), and 1541 who had a record of both dementia or mild cognitive disorder and self\u2010harm (the dementia and self\u2010harm subgroup). We examined the rates of health service use (inpatient hospital admissions, emergency department presentations, and mental health ambulatory days) for these cohorts. Using random effects Poisson regression and survival modelling, we investigated the change in and predictors of health service use following self\u2010harm (for those with dementia) or dementia diagnosis (for those who had self\u2010harmed).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>People with dementia who self\u2010harmed had the highest rate of use of all health services. Ambulatory mental health service use increased after self\u2010harm for people in the dementia cohort, while emergency department and mental health related hospital presentations decreased. Hospitalisations for non\u2010mental health reasons increased after dementia diagnosis for those in the self\u2010harm cohort, but use of other services decreased. Ambulatory mental health service use predicted increased time to re\u2010presentation to hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Health service use changed after an episode of self\u2010harm for people with dementia. People with dementia with poor mental health or substance use concerns may benefit from more proactive provision of mental health services.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/gps.70253","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T10:22:16Z","timestamp":1788344536000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Use of Health Services by People With Dementia Who Self\u2010Harm in New South Wales, Australia: A Data Linkage Study"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0801-2316","authenticated-orcid":false,"given":"Adrian R.","family":"Walker","sequence":"first","affiliation":[{"name":"The Department of Developmental Disability Neuropsychiatry Faculty of Medicine and Health UNSW Sydney  Sydney New South Wales Australia"},{"name":"Centre for Big Data in Health Faculty of Medicine and Health UNSW Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6252-1368","authenticated-orcid":false,"given":"Preeyaporn","family":"Srasuebkul","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health National Centre of Excellence in Intellectual Disability Health UNSW Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7685-2977","authenticated-orcid":false,"given":"Julian N.","family":"Trollor","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health National Centre of Excellence in Intellectual Disability Health UNSW Sydney  Sydney New South Wales Australia"},{"name":"Centre for Healthy Brain Ageing School of Clinical Medicine Faculty of Medicine and Health UNSW Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7811-5225","authenticated-orcid":false,"given":"Anne P. F.","family":"Wand","sequence":"additional","affiliation":[{"name":"Speciality of Psychiatry Faculty of Medicine and Health University of Sydney  Camperdown New South Wales Australia"},{"name":"Discipline of Psychiatry and Mental Health Faculty of Medicine and Health UNSW Sydney  Sydney New South Wales Australia"},{"name":"Older Peoples Mental Health Service Sydney Local Health District C\/o Concord Centre for Mental Health  Concord New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1405-7932","authenticated-orcid":false,"given":"Brian","family":"Draper","sequence":"additional","affiliation":[{"name":"Centre for Healthy Brain Ageing School of Clinical Medicine Faculty of Medicine and Health UNSW Sydney  Sydney New South Wales Australia"},{"name":"Discipline of Psychiatry and Mental Health Faculty of Medicine and Health UNSW Sydney  Sydney New South Wales Australia"},{"name":"Eastern Suburbs Older Persons Mental 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