After recruitment, an investigator not affiliated with clinic services met with the participant and case manager (or psychiatrist, if no case manager was involved) to discuss and record the participant's preferences for the plan's content. To finalize it, the investigator held a meeting with the participant, case manager, psychiatrist, and other relevant professionals. The investigator encouraged the participant to bring a caregiver, friend, or advocate. The aim was to discuss stakeholders' views on crisis management and to negotiate mutually acceptable solutions. The selection of information and the exact wording were the participant's choice alone. Legal documentation was not used because New York State advance directive legislation does not cover advance instructions.