Former Vermont Gov. Howard Dean called President Donald Trump “mentally ill” during an appearance on MSNBC on Sunday, noting the president is an “outlier” who — according to Dean — lacks respect from his peers.

It was an interesting comment from someone whose presidential ambitions were dashed by emitting a primal scream in public; 12 years ago, just after the 2004 Iowa caucuses, Democrat Dean raised his voice, balled up his fist, and howled — in a startling public display that ended his hopes for the White House.

“I’ve long believed the president is mentally ill,” Dean said, as part of a panel discussion hosted by Alex Witt.

“And I believe narcissism overcomes his ability to know A) what’s good for the country, and B) what’s good for him.”

He also said, “Trump has been an outlier since he’s been president, and he’s not a particularly well-respected person. He wasn’t very well-respected when he was in business in New York, and he’s not very well-respected now.”

The former governor and former chairman of the Democratic National Committee argued that Trump won’t “change after 70-odd years.”

The MSNBC interview took place as controversy surrounding Sen. John McCain’s funeral swirled; President Donald Trump was not invited to the state funeral after a contentious history between Trump and McCain.

McCain caused an uproar when he went against the Republican Party and rejected Trump’s proposed repeal of Obamacare. Trump then lashed out at the Arizona senator for obstructing his bid to change an Obama-era policy.

Trump remained largely quiet regarding the McCain funeral, and he received some praise from conservative commentators for allowing Air Force Two to be used to transport both McCain’s family and the casket itself.

Radio host Mark Simone tweeted out, “One thing Meghan McCain and the networks forgot to do was to thank President Trump for personally going out of his way to lend Air Force Two, which only he could authorize, to the family to fly them and the casket to D.C. for the funeral.”

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Meghan McCain echoed Howard Dean’s concerns in her eulogy to honor her late father.

She took aim at Trump’s tactics and criticized “cheap rhetoric from men who will never come near the sacrifice he [John McCain] gave so willingly.”

Related: The John McCain Eulogies Deliberately Slammed Donald Trump — Was This Right?

Trump’s mental health has been questioned before — as liberals struggle to deal with his leadership style.

In his best-seller “Fire and Fury: Inside the Trump White House,” author Michael Wolff alleged that several of those surrounding the president had become aware that “his [Trump’s] mental powers were slipping,” as Newsweek and others reported.

Many people went after Wolff’s book for shoddy reporting, and it quickly slipped from the national conversation.

See more on Dean’s comments on the president in the video below.

(photo credit, article image: Donald TrumpCC BY-SA 2.0, by Gage Skidmore)