To speak to your analogy, three big differences here are that:
- The orderly is just as crazy as the patients
- The opinions I'm barging in to ridicule are luxury, high-status opinions whereas mental patients are so low-status that it's effectively legal to torture them
- In addition to merely being crazy and thinking the CIA is in your cheeriors or being suicidally depressed, the people I'm barging in on are morally repugnant and actually are openly scheming against people like me