Reviewed by: Pavel Kornilov, MD, psychiatrist · updated 6 Nov 2026
Key facts
- Who leads care
- The psychiatrist on duty, then your treating doctor or psychotherapist
- Format
- Urgent video or phone call, followed by follow-up contacts
- Duration
- First contact 30–60 minutes, follow-up support for 1–4 weeks
- Anonymity
- Medical confidentiality under Kazakhstan law; full name not required
- When it's urgent
- Danger to life — 103 or 112; children and young people — the 150 helpline
- Outcome
- Stabilization, a written safety plan and a route to further care
What you should know
Why does it feel as though there is no way out during a crisis? Under severe stress, thinking narrows: attention locks onto the threat, and the ability to see alternatives temporarily declines. This is known as “tunnel vision.” Clinical guidelines on crisis care follow a simple sequence: ensure safety, reduce acute tension, restore connection with other people and make a concrete plan for the coming hours and days. All of this can begin over a video call.
A crisis rarely comes at a convenient time — more often at night, on weekends or after a hard day at work. At Psychiatry Online, a psychiatrist on duty is available around the clock. Someone in Baikonur or Saryarka district does not need to cross the city in a blizzard: a phone is enough. Online help does not replace an ambulance when life is in danger, but it helps you quickly understand what is happening, get initial support from a specialist and not be left alone with the pain. You can even start the conversation without a camera if that feels easier.
When crisis help is needed
- thoughts that life is not worth living, or about your own death
- a feeling that the situation is unbearable and there is no way out
- panic that cannot be stopped, a fear of going crazy
- a sudden loss of a loved one, a job or a relationship after which “everything fell apart”
- several sleepless nights in a row, being unable to eat or work
- an urge to abruptly “drown out” how you feel with alcohol or pills
- a loved one talks about saying goodbye, gives things away or suddenly becomes calm
If at least two points apply and the state lasts longer than two weeks, it is worth seeing a specialist. Phone consultation is free. If life is at risk, call 112 or 103.
What triggers a psychological crisis
A crisis occurs when the load exceeds available resources: bereavement, divorce, job loss, debt, serious illness or violence. The mechanism is linked to the stress response: the brain switches into survival mode, sleep is disrupted, and the ability to plan and ask for help declines. If depression, an anxiety disorder or addiction was present beforehand, the crisis develops faster and is experienced more severely.
Isolation plays a major role. During the long winter, with strong winds and short daylight hours, a person leaves home less and sees loved ones less often, which means there is no one nearby to notice when things get worse. A heavy work schedule also eats into recovery time. That is why crisis care targets not only symptoms but also restoring connections with other people.
How an online crisis consultation works
You contact the clinic by phone or through the website, and the psychiatrist on duty joins a video call. If turning on the camera is hard, you can start with a voice call. The doctor will calmly ask what happened, whether you have thoughts of death, whether there have been any attempts, whether you have taken alcohol or medication, and who is with you. Then a safety plan is drawn up together: what to do in the next few hours, whom to call and how to get back in touch.
If there is an immediate threat to life, you have already harmed yourself, or you have taken a dangerous amount of medication or alcohol, call 103 or 112 — in this situation the online doctor will also help call an ambulance. For children and young people, the 150 helpline is available. At high risk, hospitalization may be needed; it is carried out in the manner established by the law of the Republic of Kazakhstan.
How we help
Risk assessment
The doctor asks direct questions about thoughts of death, intentions, plans and protective factors. This does not provoke anything; it helps determine how urgently help is needed. Based on the answers, the route is decided: online follow-up, a psychiatrist's home visit, an ambulance or hospitalization. The doctor explains the decision and discusses it with you.
Safety plan
A written plan is one of the proven methods of crisis care. It lists early warning signs, ways to calm down, people and places you can turn to, and the numbers 103, 112, 150 and the clinic's phone. The plan is kept on your phone and discussed with loved ones if you agree. It is reviewed at every subsequent session.
Stabilization and sleep
In a crisis it is important to restore the basics: sleep, food, water and the presence of loved ones. The doctor teaches simple techniques for reducing tension — breathing, grounding and shifting attention. If necessary, short-term medication support from the relevant drug classes is discussed; it is prescribed in accordance with the legislation of the Republic of Kazakhstan.
Support after the crisis
The risk of renewed deterioration is higher in the first weeks. That is why the clinic schedules follow-up contacts — the next day, a week later, and sooner if things get worse. If depression, anxiety or addiction lies behind the crisis, the treating doctor starts treatment of the underlying disorder and psychotherapy so that the situation does not repeat itself.
Myths and facts
MythAsking about suicide can push a person to act
FactResearch shows the opposite: a direct question does not increase risk and often brings relief. The person feels they are being taken seriously. Knowing how to ask is an important part of helping.
MythPeople who talk about death won't go through with it
FactTalking about death is a serious warning sign. Most people who have made an attempt had previously spoken about their thoughts. Any such words are a reason to seek help: 103, 112, 150 or a psychiatrist.
MythOnly strong willpower helps in a crisis
FactA crisis is a state in which a person's resources are temporarily exhausted, and relying on willpower does not work. Asking for help is not weakness but the most effective step. In most cases the acute state passes faster with support.
How an online appointment works
- Message or callWrite on WhatsApp or call — our coordinator replies within minutes, day or night. You don't have to give your surname.
- Doctor and timeWe match you with a psychiatrist, addiction specialist or psychotherapist and agree on a time — often the same day.
- Video consultationA secure 50–60 minute video call: the doctor takes a detailed history and uses standardised scales if needed.
- Treatment planYou receive a clear summary, recommendations and a plan: what we do online and what needs an in-person visit or home call.
- Follow-upOnline follow-up sessions, messenger contact with your doctor, and treatment adjustments until you get a stable result.
Prices in Astana
| Urgent online psychiatrist consultation | 18 000 ₸ |
| Consultation for relatives | 15 000 ₸ |
| Psychiatrist home visit | 45 000 ₸ |
The final cost is agreed before treatment starts. Prices are in tenge and do not constitute a public offer.
Where to get help
An online consultation for “Online psychiatric crisis support” is available to people across Astana and Akmola Region 24/7 — from home, work or while travelling. For an in-person visit, Psychiatry Online in Astana has two branches: 72 Bogenbay batyra St., Astana and 37 Petrova St., office 23, Astana. Doctor home visits: all city districts and nearby settlements.
Confidential and private
An online appointment in Astana is first of all about privacy: no clinic visit, no waiting room. A private room and headphones are enough. Data is stored in a secure system with restricted access and does not enter any state registry without legal grounds.
Questions and answers
How quickly can I reach a psychiatrist?
The doctor on duty usually gets in touch within an hour, around the clock. If you cannot wait and your life is in danger, call 103 or 112 right away. For teenagers and young people, the free 150 helpline is available.
Can I seek help for someone else?
Yes. If a loved one is talking about death, behaving unusually or you are afraid for them, an online psychiatrist will help assess the situation and advise you what to say and how to act. If there is an immediate threat, call 103 or 112 without waiting for a consultation.
What if I'm embarrassed to turn on the camera?
Start with a voice call — that is enough for initial help. The doctor does not judge your appearance or surroundings. It is important to be honest about your thoughts and about anything you have taken so the risk can be assessed correctly. You can turn the camera on later, when you feel better.
Will anyone be told that I sought help?
The information is protected by medical confidentiality under the Kazakhstan Code “On Public Health and the Healthcare System.” Exceptions are provided for by law — for example, when there is an immediate threat to life and the doctor is obliged to ensure that help is called. Your employer will not find out about the consultation.
Is hospitalization needed in a crisis?
Most often not: online follow-up and a safety plan are enough. Hospitalization is considered when the risk is high and safety cannot be ensured at home. It is carried out voluntarily or in the manner provided for by Kazakhstan's law, and the doctor will explain every step.
What happens after the first consultation?
You will receive a safety plan and the date of your next contact. At Psychiatry Online, follow-up sessions take place online at a convenient time, including after work. If depression or an anxiety disorder lies behind the crisis, the doctor will offer treatment to reduce the risk of it happening again.
Where can I be seen in Astana?
Online — from anywhere in the city or region. In person — at two branches: 72 Bogenbay batyra St., Astana and 37 Petrova St., office 23, Astana. Both are open 24/7; home visits cover all city districts and nearby settlements.
Sources and methodology
This page was prepared by the Psychiatry Online medical editorial team based on:
- International Classification of Diseases ICD-10 and ICD-11, World Health Organization
- Clinical diagnosis and treatment protocols of the Ministry of Health of the Republic of Kazakhstan
- Code of the Republic of Kazakhstan “On Public Health and the Healthcare System”
- NICE (UK) and APA (US) guidelines on the treatment of mental disorders
- WHO recommendations on telemedicine and digital health
This information is for reference only and does not replace a consultation with a specialist. Editorial policy
