Speaking as a mentally ill person - could be both. A lot of mental illness isn't just a silent struggle, it also sometimes turns people into total fucking assholes. (Just look at Kanye. Many people with BPD don't get that bad, but you get the idea.) The reason we HAVE a mental health crisis in this country is that we focus on "palatable" and illnesses like depression, anxiety, etc that "normal" people have, and even those don't get nearly the amount of attention and care they require. Shit that turns people into crazy rambling assholes in public looks like a character flaw, it makes us uncomfortable, those people aren't DESERVING of help - so they wind up homeless or in body bags.

Either way, the kind of indoctrination going on in right-wing America lately and the disordered thinking any sort of indoctrination causes functions very similarly to mental illness anyway, in that those people are still very much at odds with fucking reality. I think guy's an asshole, but there's probably also something seriously wrong in his brain that makes him think this is the way he should spend his time.