Very interesting question. I do not think the burden to reconcile the two is necessary. I do not see the tension between the two at all. Unless one is to assert that mentally disabled people are in some way less than human, the issue of the Imago Dei and mental disability are not in contrast. In fact, it is the understanding of the Imago Dei that actually protects and treasures the inherent value of the mentally disabled person. Any other system of thought must either borrow capital from Christianity or believe that the mentally disabled are a nuisance to humanity. The consistent atheist would see the mentally disabled as needing to be disposed of as they are weak and are holding back evolutionary advancement. Most world religions would see them as cursed by God and under his judgment. It is the Christian who looks at the mentally disabled and can say that despite their mental disabilities, they are precious and valuable beyond measure because they are made in the image of God. Now much can be said about what the "imago dei" is and why it isn't lost within a mentally disabled person. Given this context, suffice it to say that it relates to way more than a person's intellectual faculties. The Imago Dei speaks primarily of the relationship man has to God and not man's abilities within himself. Man is the only being that God has "covenanted" with. Again, when most people think Imago Dei, they automatically assume man's sentience as being the defining marker of it. I would argue that it definitely plays a role but more deeply the Imago Dei relates to man & God's relationship to one another, specifically in the form of covenant. This is a very complex issue and unfortunately this medium isn't the best format to discuss it at length.
So if Mental Disability and the Imago Dei are not at odds, then what aspect of Christian Theology speaks towards Mental Disability? I would argue it is the understanding of "Biblical Anthropology" or the Doctrine of Man. Man was made as the crowning achievement of God's created Order. However, When Adam sinned, death in all its forms came into the world. All sickness, disease, and infirmities are the direct result of the fall. Mental Disability exists because sin, sickness, and death exist. As some people are born with physical disabilities, others can be born with psychological ones. Now there are a lot of psychological diagnosis within modern medicine which are actually spiritual issues but there are also mental disabilities which are truly physiological. These disabilities are the effect of the fall and people are born with disabilities not because they are cursed but because all of nature is under a curse and they are a part of nature. Until they repent and believe, they are enemies of God. When they repent and believe, their infirmities may still exist but they are promised a glorified state in Christ in which no infirmities will exist as Jesus rules as the sinless last Adam on the New Earth.
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