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Psychosis is a severe mental derangement that often results in delusions and loss of contact with external reality. So, a judgement of psychosis should not be made lightly, especially by an unqualified layperson. In less extreme cases, it is perhaps best to assume that claims of spiritual experiences are genuinely held, or at worst puffery, unless the person really is out of touch. Alternatives to the extremes of religious delusion and psychosis include fraud, attention seeking, a possibly warped sense of mission and so on.

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Q: How can you tell if a person is expressing spiritual beliefs or is psychotic?
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