Is this like a hill start in a car? If it weren't used on a hill would the train roll backwards?
To some degree yes, but it is used every time the train is moved from a standing start to prevent any sort of rollback, in a 387 for example it’s a button we can press at any time when stationary and it will release as soon as power notch 2 is selected, in different Electrostars it works slightly differently, some it’s a button you hold on the Combined Power Brake Controller and release when you want the brake to release which is how the hill start works on a 165/166.
On an 800 it’s automatic and the driver doesn’t need to do anything to engage the hill start unless it’s in train wash mode.
Any train rolling back for any reason of any distance seems to be a really bad thing