As one who has dealt both personally and professionally with Maryland's mental health system, I feel compelled to respond to reader Aileen Kroll's letter about the state's weak civil commitment law for people suffering from severe mental illnesses ("Problems at Perkins will continue until Maryland broadens access to treatment for the severely mentally ill," Nov. 18).

First, I fail to see the connection between the two murders this year at Clifton T. Perkins Hospital Center and Ms. Kroll's advocacy of assisted outpatient treatment, also known as outpatient commitment.

The patients at Perkins were obviously receiving treatment, since they were already in a hospital setting. Outpatient commitment is court-ordered treatment for people who reside in the community and are in no way involved with the criminal justice system.

If the discussion is about in-hospital violence, some valid responses would be to implement competent care, effective trauma services and better security within state hospitals, all of which are presently lacking.

Regarding the problems of people with mental illness who are not being treated effectively in the community, in most cases It's not that these individuals have refused to seek help but rather that the resources they need are lacking.

Instead of stripping people experiencing a mental health crisis of their self-determination and dignity — both essential elements for recovery — by forcing medication and treatment plans on them that restrict where they can live and how they can spend their days, we should be addressing the lack of resources in community mental health systems.

Outpatient commitment is condescending and essentially places the burden for getting well on the person suffering the illness. It prescribes services instead of providing options and makes the recovery of one's mental health more challenging.

The focus should instead be on broadening the quantity and quality of services, such as mobile crisis teams and supportive housing.

Studies have shown that outpatient commitment often doesn't lead to recovery for those in crisis or improve public safety. So why should we pursue a treatment strategy that belittles those it is supposed to help, inhibits recovery and has proven ineffective for all involved?

Lauren Grimes