for addiction.com

“What’s that clicking I hear in the background?” a woman says into the phone. “You’re playing with the clip? Do you have the gun right with you there, too? Okay … could we agree to not use it while we’re on the phone; that would make me feel comfortable. Can we agree to that?”

The man on the phone, a 20-year-old Marine, consents and he and the woman on the other end of the line, Maureen, continue their conversation. Maureen is one of the responders featured in Dana Perry and Ellen Goosenberg Kent’s documentary, “Crisis Hotline: Veterans Press 1.” Nominated for Best Documentary Short at this year’s Academy Awards, “Crisis Hotline” focuses on the responders at the Veteran’s Crisis Hotline (800-273-8255) in upstate New York – the only call center in the U.S. serving veterans in crisis.

A crisis line specifically devoted to the needs of veterans has perhaps never been so needed. Post-traumatic stress disorder (PTSD) and other depressive disorders are common among those who’ve served in the military. The result has been a disturbingly high number of suicides: In 2013, the Department of Veteran Affairs (VA) estimated that veterans were killing themselves at the rate of 22 per day – nearly one death per hour. Since then, that number has shown no sign of diminishing. In fact, some estimates of the daily suicide rate of veterans put the number at closer to 30 or 35.

“I wanted to do something to highlight this issue,” says Perry, a producer of the documentary. “I just didn’t know exactly what shape that would take. Then I stumbled across the hotline.” Goosenberg Kent, also a producer, and Perry initially underestimated how raw their footage from the hotline would be; the filmmakers also didn’t know just how much the hotline’s responders truly serve on the front lines (so to speak) of suicide prevention. “At first I thought it was a sort of dial-a-therapist thing,” Perry says. “But it’s much more about being right there and interrupting the [suicidal] impulse.”

It is exactly these moments between veteran and responder that make the film so gripping and emotionally grueling. Responders are often in a minute-by-minute countdown in which they must balance stopping a vet from making an irreversible decision while enabling local authorities or a loved one to get to the person in time. It’s a tipping point that many veterans reach in part because they haven’t received adequate mental health care (most of the calls received are from vets who have returned home, but the hotline also gets calls from active-duty members). “In the military culture, one of the biggest challenges [veterans] face [in getting help with mental health] is this ‘man-up’ ethos,” Perry says. “If a man or a woman in the service is struggling with depression or PTSD, it’s very isolating. And there’s a huge amount of bullying around this issue.”

Concerns about the stigma of appearing weak for struggling with PTSD don’t disappear when a soldier returns home. “There’s a fear that speaking up about mental health struggles could impact employment when these veterans return home,” adds Perry. One way that hotline responders tackle the misperception of depressive disorders as weakness is by reframing the question. “When you were over in Afghanistan and you were facing battle you did things to prepare yourself for that battle, is that right?” a responder asks a vet in a firm, low voice. “You would have a weapon that worked, you would have protective gear. What I hear is, you’re home and you’re facing a battle that’s just as serious as the one out there, and you’re doing it without the proper support.”

What Happens at Home

Coming back is, in fact, especially difficult for many who have served. Says Perry, “you’re not really the same person after you have seen battle, and then you’re just dropped home and expected to integrate back into your old life.” The result, she says, can be an overwhelming feeling of isolation: “You don’t have a job, your family treats you like a different person and you have the feeling that no one really understands what you are going through,” she says, explaining what she learned from the responders and heard on the many calls she listened to while filming “Crisis Hotline,” which was produced by HBO and released in 2013.

About one-quarter of those that staff the hotline are veterans themselves; sometimes only another vet can really understand the horrors of war, after all. “No veteran will tell you that they went to war to kill a child,” one of the responders says in the film, looking past the camera. “Talk to a Vietnam veteran –– they were told to shoot anything that moves. Can you imagine what that must be like? To be 17 and scared out of your mind and told to shoot anything that moves … and then realize it was a family?” The responder shakes his head, asking incredulously, “What’s that like?”

Untreated or under-treated PTSD, depression, anxiety or another issue (including addiction) takes a toll on the whole family, of course. In fact, many of the callers to the Veteran’s Crisis Hotline are spouses or parents desperately worried about their loved one. “There was a call [that didn’t make it into the film] where a wife was calling and there was a situation where [the veteran] was threatening her with a knife and there was a baby in the room,” recalls Perry, who has produced or directed a number of other documentaries, including “Top Ten Monks” and “Boy Interrupted.” “The responder got them both on the phone and was able to diffuse the situation and keep everyone safe.”

Whether or not Perry and Goosenberg Kent take home a gold statue on Sunday night, Perry hopes that the film’s Oscar nomination will draw attention to the good work the hotline is doing and also the need to expand the service to help more veterans and those who care about them. “People ask about giving money so that more hotlines can be established,” says Perry. “I tell them to just give money to this hotline — this is the one that’s working. It’s the one bright spot in a lot of pain and sadness.”

If you are a veteran who needs help or you know someone who is in crisis, call 800-273-8255 and press 1, or send a text message to 838255 to receive confidential support at any time. There’s also an online chat option.

Photo courtesy of HBO Films