Question

Hello.
A person who is mentally incompetent—that is, not aware of reality, suffers from psychotic or schizophrenic delusions, and the like, imagines all kinds of things, and because of this is unable to function in day-to-day life. And a person who, because of a certain mental problem, truly cannot control his actions—for example, people who because of a certain trauma cannot control sexual urges because of rape or sexual abuse, Heaven forbid, or cannot control alcohol consumption and the like because of trauma from physical injury and severe physical abuse.
The first type—people with brain and neurological problems who are completely psychotic or completely schizophrenic, and likewise people with complete deafness and the like, or those with Down syndrome or Asperger syndrome—I assume are completely exempt from commandments.
And the second type, I assume it depends on the degree to which they are “enslaved” to the mental impairment, and how free they are. (In such cases, of course, one can “come out of it” and continue living a normal life.)
But my question is this:
The first group, who are not at all aware of reality—obviously one cannot expect them to arrive at an intellectual conclusion about the existence of the Creator, certainly not to observe commandments.
And the second group—to what extent can one expect a person whose daily life involves coping with a challenge that for him is unbearably difficult, such as maintaining the most basic ethics (polite relationships, preserving physical and mental health, coping with suicidal impulses), and in addition to that also keeping commandments, and in general devoting time to reaching the conclusion that there is a Creator of the world?
Of course, one may assume that there would be “leniencies” in the heavenly court toward such people (so long as they did not at least violate things that human reason universally tends toward, such as theft, murder, and the like).
But are they obligated at all to serve God? Is there value to their religious acts? After all, for an act to have religious value, you have to be a person of sound mind who, by virtue of an intellectual or intuitive conclusion, chooses to serve the Holy One, blessed be He.
If a mentally incompetent person, suffering from the severe mental illness I described and not at all aware of reality, nevertheless chooses to keep commandments because he heard that this will earn him Heaven and eternal life, and in his mind he also imagines the Holy One, blessed be He, speaking, and imagines pictures of reward and punishment and Heaven and so on—is there value to his observance of commandments? (After all, he is not a person of sound mind.)
And an additional question, moral but also religious:
Do such people have the right to have children?
After all, when a person comes into the world, he automatically is also obligated in all obligations and commandments. And when a parent is ill and not aware of reality, he cannot give the child the tools at all, and cannot pass on to him or make him aware of his obligations. And perhaps there is actually here a stumbling block in bringing a soul whose potential is to sin