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Jewish law differentiates between a person who has the capacity to understand and one who does not. Thus we find the law treats people differently based on their mental capability- it is also this need to have the ability to understand that exonerates children and why we do not see a child as being capable of sin until after the age of Bar/Bat Mitzi.
When it comes to the mentally ill person, a major place where we learn that they are not culpable is in the laws of capital punishment in Mischa Sanhedrin. In Mischa Makkos where the giving of lashes is discussed, the same point is raised and thus they can be discussed together.
Essentially, before a person can be found guilty of a crime with a physical punishment i.e. capital crimes or lashes, there need to be two witnesses. These witnesses must not only have observed the crime, but must have warned the person beforehand. More than that, not only must the person have been warned, but they must have acknowledged the warning and then gone on to do the act.
This is where issue of mental capacity is raised. If the mentally ill person had the capacity to understand the warning at the time, and the cap city to meaningfully answer and acknowledge the warning, then they have the capacity to be found guilty for their crime. However, a mentally ill person who lacks this capacity cannot be said to have received a warning since they did not have the capacity to understand it. Thus, they did not receive a warning as it was not understandable to them- just as if the warning is given in a language the person does not understand it is as if no warning was given! Thus for such a mentally ill person we cannot use capital punishment or any physical punishment.
When it comes to their general well being, they should be treated and cared for, hopefully to the point they recover and are well again. Rambam makes this point in his works, both in his medical writings and his religious writings where he discards the idea of possession/spirits for mental illness and insists on medical treatment for it.
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