Entertainer Kanye West is again making headlines for offensive comments, this time after espousing views on social media and television (and on a T-shirt!) that appear to reflect sexism, bias, and bigotry. As he has publicly spoken about his history with bipolar disorder, having been diagnosed in 2016 after emergency psychiatric hospitalization, many have not known to react to his latest outbursts. In fact, they have raised a fundamentally complicated question: to what extent do psychological disorders excuse racist or sexist outbursts?

Mental illness can be particularly devastating for many reasons, and it can certainly cause people to behave in ways that don’t align with their true characters. For instance, addiction can compel formerly considerate people to steal from their loved ones. Dementia can turn formerly friendly and welcoming people accusatory, aggressive, and suspicious. Depression can make formerly social people ignore their friends and isolate themselves. And delusions—present in several mental health disorders—can convince formerly reasonable people that they are being targeted and act out accordingly.

So, does the context of Kanye West’s mental health problems explain his behavior? Does it excuse it? In my opinion, it depends on what we mean by “explanation” or “excuse.” I doubt that, in this case, mental health problems are a totally sufficient explanation on their own, since Kanye’s words and actions do reflect toxic societal messages like misogyny that plenty of people without diagnosable mental illness espouse.

So there’s a cultural illness that he is potentially falling prey to—and his actions are not independent of that. We have certainly seen the tragic and catastrophic effects of anti-Semitism historically, for instance, when entire swaths of people embrace such beliefs without a diagnosable mental illness. So I don’t think we can separate the idea of mental illness from that potential cultural illness completely, in terms of making mental illness “explain” all of his actions. Plus, we don’t really know what the “real” Kanye—however, he may define that, in lucid moments—thinks. However, we certainly can’t dismiss the mental illness aspect out of hand, either. They are intertwined in this case—the culture and the illness.

But Kanye’s case is unique and particularly damaging when it comes to the national discourse because he wields so much power and such a tremendously large platform with his words. This is not an everyday citizen muttering something in a grocery store aisle (which can certainly be damaging in its own right.) So, because the effect of his words is potentially so vast, I think “excusing” is too simplistic.

There’s a savviness to his power, which makes you wonder what his team is doing behind the scenes, whether it’s hard for them to stand up and get him back into help, and whether they may even be making it easier for him to continue to have such influence. But the truth is, we can’t automatically know what part of his outbursts are due to potential mania or delusions and what part is a true, deeper alignment with these upsetting beliefs. In an ideal world, West would have the time and space for treatment, and the world would understand that his messages are tainted and not to be followed.

The attention given to West’s situation makes some folks wonder where we draw the line. How much of a pass do we continue to give a celebrity, no matter the reason for their behavior, when their actions are causing real harm? The effects of West’s words are tremendously negative, whether he has a mental illness or not, and many will follow his message without exception.

That’s why we as media consumers owe it to ourselves to try to mitigate those effects—by not inflaming them or shining too big a spotlight on them, which hurts the affected communities further. This is where it’s up to the people who care for him to try to start limiting the damage—which is a struggle, of course. And in this high-profile case, I am sure it is even more complicated than for those in everyday life who know this struggle immensely with their own loved ones suffering from psychological disorders.

In short, we can’t conflate mental illness with bigotry. There can, of course, be overlap, but psychological disorders and bias are at their heart, two distinct problems requiring different solutions. If we assume that every person with mental health issues is prejudiced against certain ethnicities, that does those with mental health issues a disservice and increases the stigma of mental illness, which ultimately keeps people from getting help. And if we assume that every person who spouts off bigoted beliefs has a mental illness, we are turning our backs on the cultural ills that we need to address in terms of systemic racism and implicit bias.

One way forward is to keep pushing back against bigoted messages in ways that don’t further escalate the situation (which would only bring more attention to hateful remarks.) For the general public, this can involve not sharing hurtful messages, not endorsing them, and not repeating them–instead, rejecting them firmly. We can also hope that anyone close to someone suffering from mental health disorders finds a way to use their voice to help that person get the support they need and move away from publicly toxic behavior.