Every Sunday, Joan Pointer, 46, rises early so she has time to dress carefully. She walks the short distance to church and sits close to the sanctuary. Sunday services are the highlight of her week.

Pointer (not her real name) has been a mental patient at St. Elizabeths Hospital for many years. Her religion has become one of her most precious possessions.

At another service for "locked ward" patients, elderly women were joined by a group of men from another ward for their weekly worship service.

This service is interdenominational, but Protestants, Catholics and Jews at St. Elizabeths have the right to attend services conducted in their own faiths if they choose.

A few of the women at this service seemed oblivious to their surroundings. Yet they responded to the hyms and prayers by mouthing the words.

One woman, blind and nearly deaf, who usually sits with her clenched fists covering her ears, appeared to relax and kept time to the music with her hand.

The 2,000 patients at the mental institution have access to an active ministry tailored to their diverse religious needs.

Chaplains run a total of 48 individually planned worship services during the week.Those patients with grounds privileges attend worship services in the chapel and confined patients attend in their wards. Jewish patients may attend a service and seder meal on Friday.

Services are informal and chaplains encourage patients to comment on the Scripture readings and sermon. No one is uncomfortable when a patient stands up to look out the window or calls out greetings to a friend across the aisle.Years ago, patients who spoke during a service were escorted from the church, according to the Rev. Clark Aist, director of Protestant chaplain activities at the hospital.

Aist said one big difference in preaching to mental patients is that "they're not afraid to contradict a sermon point. Almost every minister has had the experience of getting to a crucial point in the service when a patient gets up and says, "That's a bunch of bull---, chaplain!"

But Aist said he find these contradictions healthy and doesn't mind them. "Religion can be a significant resource to the patients here (and) I think a lot of people here have used religion as a menas of getting well."

Patients often go to extremes in their religious thoughts, said Aist. "Some cling to religion...while others resent God for making them ill."

Chaplains and staff members work together at St. Elizabeths. Sometimes patients will confide inner feelings to a chaplain that they might hide from their therapist, according to the Rev. Gerald Mustard, a trainee at the hospital.

Within 48 hours of a patient's admission to the hospital, chaplains are notified, and depending on the patient's preference, a priest, minister or rabbi visits him, and may continue weekly visits with certain patients.

One patient, tchuck, 32, attends Sunday services every week because "somehow during the rest of the week, you have a little more faith in life." He says he likes Jesus and "I...enjoy religion."

Another patient, who has been at the hospital for 19 years, says the worship services and his religious be iefs help him "work out problems" in his life.

Edward, 29, dressed casually in shorts and a hat, said his religion doesn't influence his "healing," but he likes to attend Sunday services because they're "inspirational."

Preaching in a mental hospital is a very delicate issue, according to Aist. "You don't talk about an eye for an eye or plucking an eye or cutting off a limb if it offends you. They might just do that."

"The essence of what we do," said the Rev. David Carl, a Protestant chaplain, "is combine our pastoral skills with clinical skills. Not just any minister can come into the hospital and offer just any words to the patients. There's the chance they could be misunderstood."

"We try to put together a sermon which will give the patient one concrete idea he can walk away with," said Aist. "Often lessons on forgiveness, love of God and trust can help a patient understand his own problems."

"We're here to serve the patients," continued Aist. "Our worship services are designed to be meaningful to them, we're not as concerned with following tradition."

Currently, there are about 87 Roman Catholic priests, Protestant ministers and a part-time rabbi serving St. Elizabeths. The percentage of chaplains from each denomination corresponds with the percentage of patients from that denomination. According to Aist, about 72 percent of the patients are Protestant, around 23 percent are Roman Catholic and the remainder are Jewish or other religions.

This summer there are nearly 90 staff chaplains, summer interns and residents trainees at the hospital. CAPTION: Picture, A visiting friend gives reassurance to a patient, left, at St. Elizabeths during a Sunday Protestant worship service in the hospital chapel. By Vanessa R. Barnes - The Washington Post