The line between insanity and creativity is determined by appreciation, one might've considered Thomas Edison insane having made a thousand attempts at the light bulb, yet once he succeeded in his endeavor and people appreciated the bulb for what it offered, he was creative. Innovative. So it is with art, the imagination coming up with conceptual ideas then putting them into form to be a spectacle.
Some people's imaginings are profoundly disturbing, yet others amusing; when witnessing such creations one wonders where the mind of the artist is or how it got there. Are they insane or are they creative? It all depends upon your appreciation, a subjective matter.
The labeling of a person as insane would most likely be due to method, and the end result the defense upon such an accusation. Consider a method actor playing a role that requires being in numbing cold, going through freezing rivers, and eating raw meat to survive. They actually go through this ordeal for the sake of a movie, yet once the film is made, given awards. Was their method insane? It could be argued, but what of their delivery? Creative. Which brings us back to the case in point. Appreciation.