It makes a remarkable difference.
Possibly this is a bigger problem than LLMs existing at all.
And much cheaper.
E.g. if you have free internet access as an ADHD patient it’s just going to ruin your life. Make it so you have to have a video chat with your government proctor and you will help these people live successful lives no longer encumbered by these problems. The proctor would obviously refuse diagnosed schizophrenics access to LLMs.
We need to protect our most vulnerable. These tools are like heavy equipment. An impaired user will hurt themselves.