Three cheers for Sinéad O’Connor, who has this week torn down the glossy facade of the public debate around mental health. The video the Grammy-award-winner posted to her Facebook page on Monday – a motel room recording that has caused concern around the world – is not easy viewing. Seeing her desperate call for help and her honesty about suicidal feelings is excruciating. And not just because we know that she was once one of the biggest stars in the world. She expresses her pain so passionately you can almost taste it.

And I tell her this: thank you. For showing the reality of mental illness. The wailing, ranting, desperate demon that secretly tortures millions. I’ve never been to that motel in New Jersey but I have been in that room with you. Earlier this year I suffered a particularly serious mental breakdown. I have been too ashamed to talk about it publicly as I’m keenly aware of the stigma attached to pain and chaos this raw. Thank you for showing millions of us that we are not alone.

As O’Connor notes, the stigma is often worse than the mental illness itself. And while we are now used to thinking of stigma as being a consequence of mental ill-health, research shows that, in the form of prejudice and alienation, it is also a driver of morbidity. In other words, people who feel stigmatised in life are more likely to become ill and die. We know that gay, lesbian, bisexual and trans people are much more likely to suffer with poor health, as are people from minority ethnic backgrounds. Almost half of all trans kids in Britain have attempted suicide. Stigmatised already, they then face further stigma when they become ill. Talk about kicking people when they’re down.

In the past decade fantastic campaigns such as Time to Change have transformed the conversation. Matt Haig has no doubt saved many lives with his book Reasons to Stay Alive, and Bryony Gordon deserves praise for all she’s done. She landed the scoop of the year by getting Prince Harry to open up about his mental health battles. The younger royals are doing admirable work to raise awareness.

But while I applaud the efforts of these campaigners, I can’t help feeling that the conversation about mental health has, up until now, been sugar-coated and sanitised. The focus is on illnesses that seem more easily relatable – so, for example, we hear lots about depression and anxiety but no so much about schizophrenia or borderline personality disorder. Everything is past tense: battles have been overcome. The chaos is hidden.

I understand. Few people want to listen at the point when someone is struggling most. It’s too awkward for everyone involved. And who wants to show the world the depths that mental illness can take you when you’re right there at the bottom? Not me. I’ve only felt able to talk about my mental struggles in the past tense myself, as though the depression I suffered “as a student” was a neatly packaged thing I’d since tidied away. It’s not.

In addition to laudable mainstream campaigns we also need to see the reality of what mental illness can do to people up close – the same way we need to see images of people fleeing other harrowing situations for which there are political solutions if only there was the will. The world is not all roses and sunshine and Instagram filters, sadly. It is messy and, for many people, hopeless. It’s time we woke up and asked why. O’Connor has spoken openly about being abused as a child. There is no point discussing mental illness without acknowledging the circumstances that can lead to it.

I wasn’t surprised to see Annie Lennox was one of the first to voice concern for O’Connor. Lennox has spent the past 30 years expressing exquisite pain – and joy – in her music, music that has helped me find a way out of more dark tunnels than I care to remember. If only we were all as compassionate. I saw many people on social media dismiss O’Connor as “crazy” and an “attention seeker”, as though the solution is to just lock her up and forget about her. She needs love, support and understanding. Everyone struggling with poor mental health does.

As O’Connor rightly points out, though, many people lack her resources. I am university-educated and tenacious. Yet I know how difficult it is to access therapy on the NHS. I had to wait almost a year before I was accepted, during which time I ran up huge debts going to see a private therapist. God knows how people who are already not coping are supposed to deal with all the many hoops you’re expected to jump through. No wonder some people can feel like there is no way out. Yes, mental illness kills people. Suicide is the biggest killer of men under 50 in Britain. It is a real crisis.

Theresa May talks the talk when it comes to improving mental health services but it remains to be seen if she will deliver anything but bluster during her premiership. Maybe if watching O’Connor’s self-proclaimed “rant” makes us uncomfortable it’s because we are uncomfortable with our complicity in failing to address the things, such as abuse and poverty and stigma, that can drive people to mental ill-health.

There are millions of people suffering in their own private hells as we speak. Thank you again, Sinéad, for giving this secret misery a face – we need to see it.

• In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14. Hotlines in other countries can be found here

• Paris Lees is a freelance journalist, campaigner and presenter