A new documentary looks at the history of anonymous hotlines, what place they occupy in America today, and where they might fit in going forward.

"I realized that when I called these hotlines it was the first time that I had said openly what was going through my mind,” Cara Anna says. “I mean, it's one thing to just think it over and over and over and drive yourself crazy, but it's another thing to just sort of put it out there and have others hear it."

This is a quote from Hotline, a new documentary about the conversations anonymous strangers share over the telephone. To gather footage, filmmaker Tony Shaff, who's worked at a couple of hotlines himself, spent around three years interviewing both the people who call various helplines and those who answer. This includes agencies that deal with issues ranging from suicide prevention to LGBT support, Christian ministry to sexual fantasy, physic prediction to help with homework. A full array. Throughout the film, however, the multiple testimonies seem to suggest that no matter what number people dial, their underlying motive comes down to a desire for connection with another human being.

So what happens if these hotlines disappear? What happens if governments slash their budgets or corporations deem them unprofitable in an age where text-based communication has become as prevalent as people wearing socks? These are some of the questions Hotline seeks to address.

Around 30 minutes into the film, Jorge Schement, the former dean of the School of Communication & Information at Rutgers University, explains that America went through a growth spurt in the years following World War II. People began moving into the suburbs, away from family, friends, and the neighbors they knew. Since the need for advice didn't diminish during this period of newfound isolation, the result was a rise in helplines—a phenomenon, Schement says, "nobody in the first 50 years of the telephone's existence would have imagined."

Stephen DiDomenico, a Ph.D. candidate focusing on Communication Studies, also at Rutgers, tells me another shift was occurring in the culture at this time, too. Both government policy and public attitudes were starting to view debilitating thoughts of suicide as something that could largely be treated with an empathetic ear, as opposed to years of intense psychotherapy or some other medical approach fixated on biology. This led to the creation of the Los Angeles Suicide Prevention Center in 1958—America's first facility to provide 24-hour emotional support over the telephone. "It was a kind of sea change in how people thought about suicide," DiDomenico tells me. People began "acknowledging it as a health issue, and as something that can be prevented."

"Even just the idea of sharing silence with another person and knowing that the two of you are connected through a phone line for that moment is something that's important."

In 2011, the National Suicide Prevention Lifeline reported that it receives over 2,200 calls per day. In a 2013 feature story, Timenoted that the organization receives about a 15 percent increase in calls each year, meaning its annual total now stands at north of a million. Likewise, last year the Independent reported that calls to a British mental-health hotline rose by 50 percent over a 12-month period. Most people wanted to discuss anxiety related to their finances.

As to the effectiveness of all this, in 2007 the academic journal Suicide and Life-Threatening Behaviorpublished a study that conducted follow-up assessments with 380 individuals who had called a helpline in a state of suicidal distress only three weeks prior. Researchers discovered that "significant decreases in suicidality were found during the course of the telephone session, with continuing decreases in hopelessness and psychological pain in the following weeks."

A friend of mine, we’ll call him Michael, spent nearly two years volunteering at a crisis intervention and suicide prevention hotline in Vancouver, Canada. After about 90 hours of intensive training—in which he learned his task was primarily to reflect what people were saying, help them articulate their emotions, and make them feel validated in whatever they were feeling—he started answering calls.

"Anonymity can have a freeing effect," he says. "The research does show that when people don't talk about it and keep it inside, they're at a higher risk of acting on those feelings."

And yet, what would happen if every helpline disappeared tomorrow? Would the result be pandemonium, or would people be forced to seek help from those around them? By professionalizing care services, did we, as Michael put it, give ourselves permission to "flip a part of ourselves off that normally would have been integrated as a whole into the community"? Then again, perhaps anonymous helplines offer a low-barrier, low-risk gateway into talking about uncomfortable impulses. As mentioned above, they came into existence because the world was changing and society needed a way to adapt.

As mentioned in the film, today the hotline industry is confronted with our new digital reality. The New York Times reports that text-based counseling is proliferating, available at organizations such as the National Dating Abuse Helpline and National Human Trafficking Resource Center, among many others. While some fear that texting might tarnish these types of conversations due to the medium's lack of real-time interaction and tone of one's voice, others can see the positives. For one, it's a mode of communication most young people have grown up with and feel at ease using. It's also discreet. “They can still look ‘cool’ to their peers or friends while receiving assistance that they are in desperate need of,” Jerry Weichman, a clinical psychologist in Newport Beach, California, told the Times. Other advantages include the ability for counselors to handle more than one person at a time and, if the person stops responding for a few days or weeks, to pick up the conversation where it left off more easily thanks to the written record.

If anything, though, Tony Shaff's Hotline illustrates the borderline magical transformation that occurs within people when they listen to each other. The film, which recently premiered at the Hot Docs festival in Toronto, is scheduled to screen at the upcoming Brooklyn Film Festival before moving on to wider distribution later this fall.

"Even just the idea of sharing silence with another person and knowing that the two of you are connected through a phone line for that moment is something that's important," Shaff tells me from his home via landline. "Because in that silence I think a lot of information is being exchanged."