"Barack Obama is spying on me through my microwave."
Depending on what you do for a living, you could be legally (or at least ethically) bound to take action upon hearing this statement from another person. Imagine yourself in any number of scenarios – Teacher and student. Doctor and patient. Therapist and client. Service provider and customer. Supervisor and employee. Coworker and coworker. Or simply a friend, relative, or casual observer who hears an adult make that statement. Your first inclination might be to verify that the speaker was serious and not speaking figuratively. Your next would be to figure out how to get this person to a competent mental health professional for a check-up.
If your friend started posting conspiracy theories at this level of paranoia you would be alarmed. And you would be right to be alarmed; thoughts of being the subject of surveillance or conspiracies are a sign of a person in the early stages of losing contact with reality. Yet it is apparently the New Normal to have thoughts like this expressed by the President of the United States and his inner circle. Conspiracy theories are a useful tool for someone like Trump, but we have to start raising the question of how much of this is believed versus how much is spat out for calculated effect. There is no way to ascertain the truth now that the tidal waves of ridicule have washed over Kellyanne Conway. Certainly she will hide behind the "I was just kidding" defense that serves the far right so well. But I am not entirely convinced that these delusions about being spied upon are all a case of artistic license. We have to consider the possibility that these people in control of the Executive Branch believe that their appliances are being used to spy on them.
If a student said this to me and was not obviously kidding, I would be obligated to do something about it. Fortunately there are some things I could do – involve health professionals, report it to a higher authority at the university, and so on. There's nothing I can do when I hear it on the news, though, from some of the nation's most powerful people. We are taking another step toward life in a sub-Saharan style kleptocracy, right down to the crackpot dictator and his inner circle of relatives and cronies. Trump isn't necessarily Mobutu-level crazy, but he isn't necessarily sane either.