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A teenager says God and Jesus appeared to him in a grove and told him to start a new Christian church. Another person claims the Almighty talks to him through lyrics when the radio dial reads "103.1 AM," which he says refers to God, known in scripture as the "Great I Am."

A French girl gets messages from heaven to lead an army against the British, while a Utah woman thinks she is meant to have Jesus' baby and 12 husbands.

Some of these figures were considered prophets and saints, while others were judged insane. The question is: How do you tell which is which?

For example, Brian David Mitchell, convicted Friday of kidnapping and raping Elizabeth Smart, insisted that God gave him license to do so, though his attorneys argued he was mentally ill.

The main difference between a prophet and a psychopath, says Ralph Hood, who teaches psychology of religion at the University of Tennessee in Chattanooga, is "whether or not [they] can get followers."

Christian writer C.S. Lewis said that Jesus was either the son of God or "a lunatic — on the level with the man who says he is a poached egg."

And all those who started new religious movements — including Martin Luther (Reformation), Joseph Smith (Mormonism), Mary Baker Eddy (Christian Science), Ellen White (Seventh-day Adventism), Jim Jones (People's Temple) and David Koresh (Branch Davidian) — were viewed by outsiders as delusional.

But followers, ranging from the millions to the hundreds, found each of them to be credible guides to divinity.

Freud may have seen all religion, which puts its faith in an unseen power, as delusional. But today even nonbelieving therapists say it depends largely on how a person experiences the teachings and practices of a given tradition.

"There is ample research to suggest that, for the most part, religious people are no more inclined to mental illness than nonreligious people," says Wendy Ulrich, a Mormon and founder of Sixteen Stones Center for Growth, a small group of mental-health professionals, in Alpine.

The pathology arises, Ulrich says, when a person's search for meaning "goes into extreme overdrive" and people "lose touch with vital aspects of reality."

That can be a problem for psychologists and religious leaders alike — what to do when Father Jones, Brother Brown or Sister Smith says God is talking to them?

God in the mind

From the start, psychologists must weigh a person's religious and cultural expectations. The more important faith is, the more prominent a role religious language will play in a person's mental process.

Maybe the person is speaking in tongues, communing with the dead, sensing the presence of a guardian angel or getting messages from milk cartons.

So the first question becomes: Does the experience fit with some religious tradition that is dominant in a culture? Does it make sense to a particular faith community or is it out of the norm? Is it consistent with the faith's scripture, practices and beliefs or does it challenge them?

As a clinical psychologist, Brent Slife might bring in a pastor, priest or Mormon bishop to help answer that question.

"I would want to know how contextually appropriate their behavior or the things they are espousing are," says Slife, a Protestant who teaches at LDS Church-owned Brigham Young University in Provo. "Are they able to adapt to different contexts?"

Unbalanced people may repeatedly quote scriptures or obsessively perform rituals or adopt a grander, more spiritual identity such as King David, Moses, Muhammad or Jesus. It's a way for them to earn God's approval or feel more empowered. But it's also delusional.

"If the pope says he's the Vicar of Christ, that's OK because it fits with a centuries-old tradition," Hood says. "If I think I am, I'm in trouble."

Throughout history, hundreds of mental patients have believed themselves to be Christ. In the late 1950s, a Michigan facility had three patients, each of whom thought he was Jesus. Psychologist Milton Rokeach wondered if bringing the three together would force one or more of them to regain a more normal sense of self. Rokeach reported the trio's interactions in his 1964 book, The Three Christs of Ypsilanti.

It didn't work, and Rokeach later apologized for exploiting his patients.

"Very little seems to shift the identities of the self-appointed Messiahs," Vaughan Bell reported in a February 2010 essay about the book in the online magazine Slate. "They debate, argue, at one point come to blows, but show few signs that their beliefs have become any less intense."

Still, Bell writes, the approach holds up a mirror to the general population.

"We are asked to see ourselves in the psychiatric patients," he writes, "at a time when such people were regularly locked away and treated as incomprehensible objects of pity rather than individuals worthy of empathy."

Confusion of the soul

There are at least two common ways in which mental patients describe their delusional experiences with God, Ulrich says.

Schizophrenics hear voices or see things that are not there. Their hallucinations or false beliefs about reality can feel so real, she says, "that they ignore the perceptions of other people or common sense or contradictory information or experience."

Meanwhile, those suffering from paranoia see conspiracy in everyday events or think God is speaking specially to them — perhaps through the radio or the newspaper.

"They overinterpret common experiences to mean either someone is out to get them or God is out to help them," Ulrich says. "Ideas of grandiosity and thinking of themselves as special or chosen in some way are not uncommon."

But it never is easy to assess the authenticity of another person's spiritual experience.

Ulrich has known people whose behavior could be inspiring or could signal a muddled mind. Many of them take part in church services without fellow believers even being aware.

She has known some religious folks who are unusually clairvoyant, with a penchant for and openness to revelatory experiences. They largely are calm, highly functioning, rational people, who are socially engaged but don't call attention to themselves.

"They pretty much play by the rules of society and don't think of themselves as special," she says. "They know their 'gifts' are not always believed in or valued, so they have a sense of humor about them."

The Alpine psychologist also has seen people who are "very high-functioning in some areas of life and can be quite charismatic, intelligent and charming," but they begin to "overinterpret impressions or events as messages from God in ways that make other people nervous, even people within their own value system or religious system."

Such people think the "rules" of the community don't apply to them and may start to feel that others are out to get them, she says, and they don't understand why.

If you ask a religious person how God communicates, she might say through impressions or a kind of whispering. But if you ask a mentally ill person that question, he might say, "I shook hands with him yesterday."

You can tell him maybe his mind is playing tricks on him, but the patient will not be dissuaded, says Michael Measom, a psychiatrist at Valley Mental Health.

Studies show that reasoning with schizophrenic patients about God never works, Measom says. They cannot be convinced of any other interpretation.

It's a matter, he says, of core beliefs and brain chemistry.

The religious response

For a believer such as the Rev. Gregory Johnson, the line between genuine religious experience and madness sometimes is blurred.

Johnson, who directs Standing Together, a Utah group of evangelical pastors, is not a charismatic Christian, so he doesn't speak in tongues or engage in the more ecstatic practices. But he does believe God heals, speaks and leads.

"I see a range of healthiness and levels of extremity within the confines [of Christianity]," he says. "I see people who are zealous but not insane."

But Johnson has run across several churchgoers who crossed the line.

"When I hear someone say, 'God came to me in a dream or spoke to me,' I don't immediately reject it," he says. "But I would watch the behavior. If they have a sense of self-importance, needing to be the center of attention, that becomes a good warning sign for instability."

One of the tests, Johnson says, might be the "fruits" or outcomes of the divine communication. Does the experience lead a person into more altruistic actions, greater caring for others and deeper relations, or does it simply draw the recipient further into narcissism?

As a pastor, Johnson says, he would worry about actions that are "destructive to other people or to themselves."

Catholic priests also have to be "attentive to the particular experience the person is having," says Monsignor Francis Mannion of St. Vincent de Paul Catholic Parish in Holladay. "If they seem out of touch with reality, that's an important clue they might be bordering on mental illness."

It is not unusual to hear parishioners talk about experiences with God, Mannion says, but genuine mystical experience is rare.

The Catholic Church has a system for evaluating claims about Marian visitations, and few of those are judged to be authentic. Earlier this week, the church affirmed 1859 reports of a Lourdes-like appearance of the Virgin Mary near Green Bay, Wisc., the only U.S. site to gain such a designation.

"We don't pay that much attention to private revelations," Mannion says. "We pay much more attention to the constant tradition of the church and what it says about God's desires."

On the other hand, a central LDS teaching is the reality of "personal revelation."

Mormons are urged to seek and receive God's guidance for themselves and their families. But only the church's "prophet, seer and revelator" can receive messages for the whole faith and the world. Such institutional controls may inhibit individual experiences, but they do prevent mentally ill members from distracting or confusing the faithful.

Even as a young Mormon teen, Elizabeth Smart says she knew the difference between a genuine religious leader and Mitchell.

"God would never tell someone to kidnap a young girl from her family's home in the middle of the night from her bed that she shared with her sister … and sexually abuse her and give her no free agency to choose what she did," Smart testified. "I know [Mitchell] was not called of God because God would never do something like that."

Mormon physician Greg Smith in Alberta, Canada, agrees there is no comparison between prophets and psychopaths.

"Contrary to popular belief, the 'mad' are rarely very creative, very effective, very charismatic or very compelling," Smith says. "In fact, most people find them bizarre and off-putting, even if they can't put their finger on why."

That's why, he says, there are many so-called crazy people in the world, but only a few who launch global religions.