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But for someone in a wheelchair, who's responsaoility is it?
Wheelchairs are actually a great example of someone using supports to accommodate their limitations.
But do you think we should make an effort to adapt ourself, or that it is fully on them to make efforts? Such as, if they want to board a train, and it takes 2 steps, should some valid people help him? should they do nothing? should they scold him for being infront of the door and slowing others?
Wheelchairs are not a good analogy for Narcissistic Personality Disorder (NPD); but you're basically asking the old question of "who bears the burden of disability" in general right?
I don't have NPD disorder, and don't know anyone diagnosed with it; so I can't say with confidence what accommodation would look like.
You're right that it's not 100% the patient's responsibilty. I should have made that more clear in my other comment. My point was that in your wheelchair metaphor, it's the patient's responsibilty to acquire a "wheelchair" as the first step of treatment. Otherwise they're metaphorically expecting those around them to carry them around everywhere.
One of the problem with mental health, is that it is usually not obvious for the patient (at least until a proper diagnose is made). Even if you consider some severe cases with multiple sensorial hallucinations, from the patient's point of view everything is normal and logical.
So you are right that the wheelchair isn't a very good analogy. Should I suffer a physical disability, I would notice it easily. On an other hand, if I suffer of some mental disability/sickness, I would have to rely on you (on other people) to tell me about the problems so that I may look for a medical diagnose and help. Yet I am not pretending it would be easy to make me notice I may have a mental problem: I would need to use my brain to find out that my brain goes wrong, that my normal isn't normal ; and finaly find that my reality or logic doesn't match the real one (while still being in my reality).