Someone gets labelled mad less for a clear inner illness than for being uncontrollable in ways that inconvenience the people in charge. Wielding a knife, making strange proclamations and sleeping outdoors were enough to have a foreign servant locked in an asylum for years.
When two societies meet, each judges the other by its own definitions of loyalty, madness and moral obligation. Behaviour that is reasonable or dutiful by one standard can read as disloyal or insane by the other, so the clash itself manufactures the diagnosis.
Uprooting a person into a foreign world may itself produce the strange behaviour later blamed on their nature. The open question is whether he was mad before, or whether the journey West caused the reaction.
Cross-cultural contact gives birth to strangeness: each misreading creates new misconceptions on both sides. A convert chosen as the perfect assistant became, through a chain of mutual misunderstanding, a prisoner.
A sponsor who brings a dependent into his world may drop him once he becomes an embarrassment, leaving him to institutions. That raises the question of how far the patron shares responsibility for what then happens to him.