I would agree - and say that mental illness or no, things that hurt, hurt. The question is: If when called on it - if when made aware that what they are doing hurts, do they try to change? That's not the same as an apology - it means making an effort to stop doing the hurtful thing. This type of change is difficult, but can happen if the person wants to do some work - and while doing the work, it won't be perfect.