She sat across my desk and desperately longed for an answer. Should she respond to the invitation and repent of sins -- such as missing the worship assembly (cf. Hebrews 10:25) and using bad language (Colossians 3:8) -- or should she just not worry about it? This was not the first time I had been asked this question during a counseling session. But it was the first time that I did not immediately say, "Yes, you should repent."

The young lady who was sitting across from me was suffering from a mental illness -- something our society handles very poorly. Yet according to recent statistics, this woman is far from being alone. The National Institute of Mental Health estimates 22.1 percent of Americans ages 18 and older -- about 1 in 5 adults -- suffer from a diagnosable mental disorder in any given year. When applied to the 1998 U.S. Census residential population estimate, this figure translates to 44.3 million people. Of this 44 million, a fraction develops conditions that require major treatment and medication. Today 4 of the 10 leading causes of disability in the U.S. are mental disorders -- major depression, bipolar disorder, schizophrenia and obsessive-compulsive disorder. Many of these individuals possess unstable neural chemistry -- to the degree that they are unable to function in society or distinguish right from wrong.

What is Their Condition In God's Eye's?

The woman's question was valid. She knew that after she stopped taking her medication she had lapsed into a condition in which she was "not herself." She had said things she normally would not say. She had treated people in a way that she normally would not treat them. Yet, she also was smart enough to realize that this was not the first time she had been through this cycle, and that it likely was not going to be the last. So where do these individuals find themselves in light of God's Word? Are they walking "in the light," or has their lack of obedience to the Gospel caused them to place their immortal souls in danger? Should I have answered her question with an immediate, "Yes, you must repent"? In evaluating the eternal salvation of these special individuals, we must assess what ability they possess to obey God's law. If, in doing so, we deem that they are unable to discern right from wrong, how, then, can we hold them accountable? In this particular case, the individual had been without medication for over six weeks, and consequently her brain chemistry was nowhere near normal.

Mental illness often is brought about by an imbalance of chemicals (neurotransmitters) that are commonly used by the brain (i.e., serotonin, GABA). Some of these chemicals, like serotonin, are responsible for making us feel good and happy -- and yet many Americans are unable to produce adequate quantities of these chemicals. You can imagine the exasperating consequences in patients who are unable to adequately regulate several of these important neurotransmitters. If the neuronal chemicals responsible for moral conscientiousness are physiologically unstable, then it is beyond the individual's capability to observe the edicts found in the New Testament. We commonly hear the phrase "age of accountability" within the church in reference to young people who have traversed from a "safe/innocent" state into a position of being responsible to God for their actions. Aside from age and physical maturity, is someone who is mentally handicapped any different from a young child? Neither has the capability of knowing and carrying out the commands of God. Does that change God's expectations? No, it does not. God does not change. But does this mental handicap change their status in God's eyes? Most assuredly! The mentally ill possess a "safe" status when it comes to their salvation, just as young children do.

Who would ever argue that infants and young children have sinned, and thus have need for repentance? They often are of such a young age that believing and confessing the name of Christ is impossible. Thus, as the examples in the New Testament demonstrate, children are not candidates to be buried with Jesus Christ in baptism for the remission of sins. While children do not come into contact with the blood of Jesus Christ, their very nature and innocence affords them safety in the eyes of the Lord. In fact, Christ himself used children as an example when the disciples asked him who was the greatest in the kingdom of heaven: "And he called to him a little child, and set him in the midst of them, and said, 'Verily I say unto you, except ye turn, and become as little children, ye shall in no wise enter into the kingdom of heaven'" (Matthew 18:2-3). David, following the death of his son by Bathsheba, informed us that the righteous one day would meet up with their children. After learning of the child's death, David stated: "But now he is dead, wherefore should I fast? Can I bring him back again? I shall go to him, but he will not return to me" (2 Samuel 12:23, emp. added). David knew that one day he would see his son again -- a son that had been afforded a safe condition in the eyes of the Lord. The mentally ill are no different from this young baby. They, too, are unable to comprehend and follow the instructions found in the New Testament. However, this does not mean that the mentally ill will spend an eternity in torment. They, like children, have been granted safety in the eyes of God.

What Should A Christian's Response Be?

While these numbers are staggering, the church remains eerily silent on how we should treat those who are suffering. As Christians, we need to realize that we have a role to play in caring for the mentally ill, just as we have for the physically ill. Christ never avoided individuals who exhibited signs or symptoms of mental illness. Rather, he showed compassion for them, and in many occasions healed them. Why is it, then, that we remain uneasy when people with these types of disorders suddenly affect our local congregation? As Christians, we must realize the great need for caring for the mentally ill (and their families), and we must support them as they struggle to have their condition stabilized.

What should a Christian's response be toward those who are suffering from a chemical imbalance in their brain? First and foremost, we must see it for what it is -- an illness. Thus, mental illnesses should not be regarded as a weakness in the person's character. As many can attest, mental illness is not a respecter of persons. It affects the young, old, rich, and poor -- no family is immune from illness and disease. Fortunately, major progress has been made in developing drugs that can help correct these imbalances. As such, Christians should acknowledge and understand that individuals suffering from mental illness may be on a whole host of medications, as physicians try to "tweak" the brain chemistry back to a normal state. Often, this is a tightrope-balancing act of trying to find just the right amounts of a particular drug, and not having the patient's life affected in a negative way, or having them suffer from unpleasant side effects. Christians also should be aware that patients must routinely have their medications "regulated," (often in a hospital environment) as their bodies change. This is nothing for patients to be ashamed of; rather, it is simply a common fact of life for individuals suffering from this condition.

Knowing that it is, in fact, an illness, we must stop avoiding individuals who suffer from mental illness. By becoming familiar with their moods, we can better identify periods in which additional treatment may be needed. We should also educate ourselves about the mentally ill and their plight. If we are properly informed, then many of our fears, misconceptions and prejudices will vanish. As Christians, we also must seek ways to use the talents of those struck by mental illness. Additionally, we must start praying for these individuals -- that if it be God's will, they are returned to a normal state. While every congregation cannot afford full-time counselors, every congregation should be able to help someone find competent help from caring Christians. Elders and preachers cannot (and should not) be expected to resolve all of the problems the mentally ill may face. But they should be prepared to provide names of qualified Christians who can.

Since many mentally ill individuals already suffer from profound guilt, we as Christians must not add to their guilt by questioning their faith, or judging their attendance. When Christ came upon the man with the unclean spirit, he did not admonish him for his behavior. He first healed the man. It was only afterward that Jesus instructed the man, saying, "Go home to thy friends, and tell them how great things the Lord hath done for thee and how he had compassion on thee" (Mark 5:19). Consider the utter frustration you would feel, knowing you had involuntarily acted in a way contrary to God's Word during a recent episode (i.e., missing services from excessive sleep brought about by your disease), but knowing if you go forward and repent that you may be acting that same way in five-to-ten months. And yet, you know the behavior is brought about because of imbalanced brain chemistry. Our goal as Christians must be to help restore these individuals to a normal state, and care for them as they are struggling to reach that state. Jesus Christ did not avoid persons with these types of disorders, and neither should we. Our hearts should burn with compassion as we seek to serve.