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I don't have any significant mental health issues, but I can see the appeal.
Sometimes you just really need to get stuff off of your chest. Ideally you have people close to you that you can vent to, but some people don't, and even if you do, sometimes they're just the wrong kind of people to have that sort of conversation with.
And just being able to say something out loud can help you figure things out on your own. Sowe programmers and such do "rubber duck debugging" where they just explain the code and the issues they're having to a rubber duck or stuffed animal or something on their desk, and the act of talking through it sort of engages different parts of your brain and often that's enough to find the issue (I remember one time back in high school I was taking a programming class, I was presenting my project to the class, it worked, but it was a mess of ugly spaghetti code, and as I was up there explaining it out loud for the first time, something just clicked and I realized how I could have done it a much better way.) Some people feel really stupid talking to a rubber duck though (especially if it's someone who's already afraid that people think they're "crazy") so having an actual human to talk to could be really helpful for them.
And a lot of these things have other resources they can offer. They may be able to help you find a support group, therapist, housing assistance, have some sort of a crisis team they can send out to meet with you, etc.
And for what it's worth, I work in 911 dispatch. This will vary a lot around the country of course, but while we certainly do get a decent amount of calls from crisis hotlines, they're basically all for people who are in imminent danger of harming themselves. And the number of those calls I get is absolutely tiny in comparison to the amount of calls I've transferred to 988 and our police never so much as drove past the callers house.