Mental health was mentioned twice during Sunday’s Democratic presidential debate.

First, in connection to mass shootings.

“I don’t want to hear anything about tougher laws for mental health or criminal backgrounds, because that doesn’t work,” Gene Knopf, the father of 14-year-old shooting victim Abigail Knopf, asked in a question to former secretary of state Hillary Clinton and Sen. Bernie Sanders (Vt.), both of whom responded with calls for gun control.

Second, in a jab at the Republican presidential candidates.

“You know, we are, if elected president, going to invest a lot of money into mental health,” Sanders said. “And when you watch these Republican debates, you know why we need to invest in that.”

The comment drew laughter from the audience, as well as from Clinton. Everyone was in on the joke: the GOP presidential debate last week had been characterized by name-calling and innuendo-laden references to the size of Donald Trump’s hands.

As The Washington Post’s Ed O’Keefe and David Weigel wrote in the run-up to Super Tuesday, “[Trump] and Sens. Marco Rubio (Fla.) and Ted Cruz (Tex.) are hurling deeply personal attacks about one another’s appearances and personal backgrounds — amounting to a level of petty and profane discourse unprecedented in a presidential campaign.”

So when Sanders poked fun at the GOP candidates’ “mental health,” people understand exactly the behavior to which he was referring.

The problem, however, is that none of the bickering associated with the Republican race are actually signs of mental illness — and those who do suffer from such disorders are calling out Sanders’s ableism.

While the senator intended to disparage the rancor between Trump, Cruz and Rubio, he may have belittled mental health patients instead, undermining his very commitment to the issue.

In particular, Twitter users criticized the linking of mental illness to the Republican candidates’ alleged use of racial language.

Sanders’s health care plan proposes creating a universal single-payer system for all Americans, including coverage for mental health services. As chairman of the Senate Veterans Affairs Committee, he worked to expand mental health care programs, but the success of his tenure on the committee has been disputed by some veterans groups.

According to the National Alliance on Mental Illness, approximately one in five Americans experiences mental illness in a given year.

“Comparing the actual playground antics of the Republican field to the experience of having a mental illness raises their immature behavior to something sober and serious while simultaneously diminishing the seriousness of how we treat — and clearly, also talk about — mental health in this country,” Emily Willingham wrote in Forbes.

She pointed out that while Trump was widely lambasted for mocking a New York Times reporter with a physical disability, Sanders’s crack at the expense of the mentally disabled was not only accepted, but in fact applauded by the debate crowd.

“[The line] referenced people with mental illness explicitly as a means to bash Republicans,” Vox’s German Lopez concurred, “and it perpetuated the idea that those with mental illnesses are inherently dangerous.”

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