I notice a lot of people use terms like "psychotic" or "psychopath" as insults and negative descriptions on here. These are clinical terms that are used to describe real people with difficulties, not boogeymen! I don't disagree with the sentiment that these people are doing wrong, but if you wouldn't use the r-slur or "autistic" as an insult (which you shouldn't) then you shouldn't use these words either. And I get the idea of calling someone delusional, but take care that you don't just mean "I disagree with them." Though by posting on neurodiverse I imagine I'm preaching to the choir.
Sincerely, a casual schizoaffective disorder haver.
I think it's also important that the site - both moderators and users - have a culture of proportional justice rather than "Black and White" morality.
Users typically treat the "Report" button as a "I think this user should be immediately, indefinitely, and irrevocably banned" button, and are hesitant to use it in cases where they don't think such a harsh punishment is appropriate (and also because, especially on Lemmy, their account is visible to moderators who might retaliate against an apparently-overzealous reporter).
If someone calls something crazy/psycho/etc. in apparently good faith they, at worst, deserve to have their comment removed and get a bit of scoldmail nagging them about their language.
That's down to individual judgement at that point.