'Bat-shit crazy' is used to describe someone who you think is just plain crazy and beyond any hope of getting better. In reality, it's not usually used to describe a person who is truly mentally ill, but rather a person who has such outlandish, uninformed and offensive beliefs that you're sure they must be crazy.
Example:
-That presidential candidate is bat-shit crazy!
-I know! If he wins, I'm moving to Canada!
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