Self-binding directives under the new Dutch Law on Compulsory Mental Health Care: An analysis of the legal framework and a proposal for reform.

Abstract Self-binding directives (SBDs) are a special type of psychiatric advance directive by means of which mental health service users can give advance consent to compulsory hospital admission or treatment during a future mental health crisis. SBDs are legally binding in the Netherlands since 2008. On the 1st of January 2020, the Dutch Law on Special Admissions to Psychiatric Hospitals (Wet bijzondere opnemingen in psychiatrische ziekenhuizen; Bopz) was replaced by the new Law on Compulsory Mental Health Care (Wet verplichte geestelijke gezondheidszorg; Wvggz). This replacement brought with it various changes in the legal arrangement for SBDs. In this article, we expound the changes in the legal arrangement and assess the implications of these changes for the practical feasibility of SBDs. We argue that the procedures for arranging compulsory care based on an SBD in the new law are too complex and time-intensive for SBDs to yield their potential benefits. We close by proposing a workable mechanism of legal authorisation of compulsory care on the basis of an SBD.