Table 2.

Overview of results

Benefits	Risks
increased service user autonomy	infeasibility of SBDs
improvement of the therapeutic relationship	difficulty in decision-making about SBD activation
possibility of timely intervention and prevention of harm	limited accessibility of SBDs in mental health crises
prevention of compulsory care	disappointment of service users due to professionals’ non-compliance with SBDs
reduction of the duration of compulsory care and recovery	limited evaluation and updates of SBD content
mitigation of negative experiences around compulsory care
guidance for professionals in providing compulsory care
Facilitators	Barriers
support for SBD completion	lack of knowledge of SBDs among professionals
involvement of relatives and peer experts	lack of motivation or insight among service users
specification of SBD content	lack of professional support for SBD completion
evaluation of compulsory care and SBD content
Positive effects of the new law	Negative effects of the new law
stronger emphasis on service user autonomy	no clear added value of SBDs compared to other instruments for documenting service users’ preferences
legal provisions for several instruments that provide a starting point for SBD completion	lengthy and complex legal procedures for SBD activation