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BTW, if mental illness is defined by the distance between our perception of reality and actual reality, we are all insane to some degree.
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Let’s just say it perhaps is a moving target. I have regular contact with a person who was quite cognitively there a year or so ago but is on a daily basis now somehow distorting very simple messages to the point where many things now have to put down in writing so that one can go back later to say “no, that’s not what was said, that’s not what was planned, that’s not what was agreed on etc.”. As these things go, they don’t get better with the passage of time… at least when a person is in say the last half of their life….

The issue of mental illness is certainly a big topic and the roots of it are quite varied. I think that there is a tendency to classify all types of mental illness as something that originates inside the person him/herself in a physical/mental way… and this runs the gamut of causes such as chemical imbalances, trauma, abuse by others. As a Christian, it certainly is part of what I know and believe that there is a huge spiritual factor and ‘unseen world’ that plays a huge role in the psyche of the individual…. And I suspect that role is so huge that it plays the major, not a minor role. Many very mentally disturbed people have turned their lives over to God and accepted Jesus Christ as their Saviour and their mental problems disappeared. I’m oft reminded of these verses in Ephesians 6…
11 Put on the whole armour of God, that ye may be able to stand against the wiles of the devil.

12 For we wrestle not against flesh and blood, but against principalities, against powers, against the rulers of the darkness of this world, against spiritual wickedness in high places.

13 Wherefore take unto you the whole armour of God, that ye may be able to withstand in the evil day, and having done all, to stand.

14 Stand therefore, having your loins girt about with truth, and having on the breastplate of righteousness;

While these verses are slightly out of context because they apply to those who are Christians already, they clearly describe the battle with the unseen spirit world that is very real and it is even more likely to be affecting those who have no Godly spiritual grounding and anchor at all. People sometime forget that Luke was a doctor as well as a disciple of Christ and much of the Book of Luke is written from that perspective. The words ‘unclean spirits’ come up over and over in Luke…. Here is one passage in Luke 8 about this…
26 And they arrived at the country of the Gadarenes, which is over against Galilee.
27 And when he went forth to land, there met him out of the city a certain man, which had devils long time, and ware no clothes, neither abode in any house, but in the tombs.
28 When he saw Jesus, he cried out, and fell down before him, and with a loud voice said, What have I to do with thee, Jesus, thou Son of God most high? I beseech thee, torment me not.
29 (For he had commanded the unclean spirit to come out of the man. For oftentimes it had caught him: and he was kept bound with chains and in fetters; and he brake the bands, and was driven of the devil into the wilderness.)
30 And Jesus asked him, saying, What is thy name? And he said, Legion: because many devils were entered into him.
31 And they besought him that he would not command them to go out into the deep.
32 And there was there an herd of many swine feeding on the mountain: and they besought him that he would suffer them to enter into them. And he suffered them.
33 Then went the devils out of the man, and entered into the swine: and the herd ran violently down a steep place into the lake, and were choked.

Finally, Romans 1 in verses 22 to 32 describes those who leaned on their own ‘smarts, wisdom and desires’ and can be basically paraphrased like this… Mankind has free will and if you want to reject me you are at liberty to do that.... but there will be consequences because you are on your own without me. Verse 24 has to be one of the saddest verses in all of scripture “24 Wherefore God also gave them up to uncleanness through the lusts of their own hearts, to dishonour their own bodies between themselves:”

I used to live in NYC and, on weekends (when not dressed in a suit and tie), would occasionally stop and talk to homeless people (of which there were plenty).

Some were just down and out, some perhaps struggling with addiction. But some were (clearly?) possessed.

As a side note, those who I thought were possessed didn't exhibit or manifest when I spoke with them, but when you listened to them talk of their experiences, you could hear a kind of non-spoken background noise that was, well, lurking (for lack of a better word).

Of course, there were some of this crowd who were just incomprehensible. Drugs/alcohol, insanity, possession...or some combination thereof.

Side note: As a former drinker, I used to accompany a girl I was dating to her AA meetings. Some of the stories I heard there were reminiscent of what I used to hear from street people.

People who live sheltered lives behind "white picket fences" have no idea what is out there.