Nightmare park attendant blocks driver, then falsely tells 911 she's being run over

I agree 100% with the goal of minimizing the stigma of mental illness. The only thing that bothers me about this rule is this -

In this video it appears to me that it is possible or even probable that the woman knows she is lying as she’s screaming about being run over, i.e. she’s not delusional but rather acting with ill intent. But at other times we get a video with someone (practically) obviously operating from a state of delusion - times where we cannot imagine any gain from the behavior.

Sometimes the early comments to those videos are of the “Christ, what an asshole” variety, whether or not in so many words. I have sometimes brought up the possibility of mental illness precisely because I think it’d be shitty for someone who has had the same set of issues to read comments describing someone like them (or someone close to them) as mean or as an asshole or what have you.

So in the name of maximizing compassion and empathy how should we approach that situation?