Reviewed by: Assel Omarova, MD, psychiatrist and addiction specialist · updated 6 Nov 2026
Key facts
- Who leads the session
- a psychiatrist experienced in family counseling, with an addiction specialist (narcologist) when needed
- Format
- a video meeting with one or more family members; the patient takes part only if they wish
- Duration
- 50–70 minutes; follow-up meetings as needed
- Anonymity
- you do not have to give your surname or your loved one’s details
- When it is urgent
- threat to life, aggression, a self-harm attempt—call 103 or 112
- Outcome
- a risk assessment, a clear plan of action, and recommendations on communication and legal steps
What you should know
Why do family members need a separate consultation? A person with depression, psychosis, bipolar disorder, or an addiction often does not recognize their condition or is not ready to seek help. This is not stubbornness: impaired insight into the illness—anosognosia—is part of the clinical picture of many disorders. As a result, the first people to contact a psychiatrist are often family members, who see the changes but do not understand what is happening or how to respond.
Clinical guidelines assign an important role to the family: psychoeducation for relatives has been shown to reduce relapse rates in schizophrenia and bipolar disorder and to improve adherence to treatment. The online format makes it possible to bring together relatives who live in different districts—for example, Yesil and Saryarka—or even in different cities, in a single meeting without taking time off work. The patient does not have to take part if they are not ready yet.
When Family Members Should Consult a Psychiatrist
- your loved one has changed: withdrawn, stopped leaving the house, and stopped socializing
- strange ideas, suspiciousness, or a fear of being followed have appeared in what they say
- they go for days without sleep, talk a lot, overspend, and make unrealistic plans
- the person talks about life being meaningless or about not wanting to live
- regular use of alcohol or drugs is destroying the family and their job
- your loved one has stopped their prescribed treatment, and signs of the illness have returned
- you do not know how to talk to them and feel that you yourself are at your limit
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.
Why a Loved One Refuses Help
In a number of disorders, the ability to evaluate one’s own condition is impaired. During psychosis, a person perceives their experiences as reality; during mania, they feel better than ever; in severe depression, they are convinced that nothing will help. This is not a conscious choice but a manifestation of the illness, so direct arguments and pressure usually provoke resistance and damage the relationship with the family.
Fear of stigma, negative past experiences with treatment, medication side effects, and reluctance to admit “weakness” also play a role. With addictions, denial mechanisms come on top of all this. Understanding which factor is driving your loved one’s refusal determines the strategy: for one person, a motivational conversation works; for another, the offer of an anonymous online consultation; for a third, only legal emergency measures will do.
How an Online Family Consultation Works
The doctor listens to each participant: what has changed, when, how the situation has developed, whether there have been diagnoses and treatment before, and whether there are risks to life. Prepare a timeline of the changes, a list of your loved one’s medications, and medical records if you have them. The doctor then explains what the condition looks like, what options for help exist, and how to approach the conversation with your loved one. If they agree, the next meeting can include them.
A doctor cannot diagnose someone they have not seen: the consultation covers hypotheses and a plan of action. Involuntary hospitalization and psychiatric evaluation are possible only under the procedure established by Kazakhstan law and require an in-person assessment. In the event of aggression, a threat to life, a self-harm attempt, or severe confusion, call 103 or 112; Psychiatry Online can arrange a home visit by a psychiatrist.
How we help
Assessing the situation and risks
The doctor systematically checks for signs of psychosis, mania, severe depression, or withdrawal; whether the person expresses thoughts of self-harm; and whether there is aggression toward others. Based on this, the level of urgency is determined—from a planned motivational conversation to calling an ambulance immediately. This structure helps the family stop acting at random and wasting their energy.
Psychoeducation
Family members learn how the suspected disorder works, why the person behaves the way they do, what treatments exist, and how long they take. Understanding the mechanisms reduces guilt and helplessness, leads to fewer conflicts, and makes it possible to respond to symptoms more calmly instead of taking them as a personal insult.
Motivational strategy
The doctor helps you prepare for the conversation: which words to choose, what to avoid, and how to build on what matters to the person themselves—sleep, work, relationships. It is often more effective to suggest an anonymous online consultation “just to talk” than to insist on a visit to a psychiatrist. The approach to addictions, where denial is especially strong, is discussed separately.
Legal steps and family support
If the situation is dangerous, the doctor explains which actions are provided for by Kazakhstan law: calling an ambulance, a psychiatric evaluation, and hospitalization under the established procedure. Special attention is paid to the family members themselves: chronic strain raises the risk of depression and anxiety, and the family may need help too.
Myths and facts
MythIf a person doesn’t want treatment, nothing can be done
FactA lot can be done without coercion: changing how you communicate, suggesting an anonymous online consultation, or involving someone the person respects. When there is a threat to life, the law provides for emergency measures, which the doctor will explain in detail.
MythFamily members seeking help behind someone’s back is a betrayal
FactA family consultation is an act of care, not control. The doctor will not act behind the patient’s back or share information with third parties. The goal of the meeting is to teach loved ones how to help in a way that makes the person want to seek treatment themselves.
MythA serious talk is enough to bring them to their senses
FactWhen insight into the illness is impaired, pressure and ultimatums usually increase resistance. Calm observations, “I” statements, and an offer of concrete, understandable help without labels or accusations work better.
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
| Online psychiatrist consultation (50–60 min) | 15 000 ₸ |
| Follow-up online consultation | 12 000 ₸ |
| One month of online psychiatric care | 60 000 ₸ |
The final cost is agreed before treatment starts. Prices are in tenge and do not constitute a public offer.
Where to get help
Psychiatry Online in Astana: same-day video appointments and two branches for in-person visits — 72 Bogenbay batyra St., Astana and 37 Petrova St., office 23, Astana. Our mobile team works around the clock: all city districts and nearby settlements. If you live elsewhere in Astana and Akmola Region, starting online is usually easiest.
Confidential and private
Information about your visit, diagnosis and treatment is protected by medical confidentiality under the Code of the Republic of Kazakhstan “On Public Health and the Healthcare System”. We never share it with your employer, school or relatives without your consent; the only exceptions are those expressly set out by law. For an online consultation your first name is enough, video runs over a secure channel and nothing is recorded without your consent.
Questions and answers
Can a doctor make a diagnosis based on what relatives say?
No. The doctor can offer a hypothesis and assess the risks, but a diagnosis is made only after examining the person themselves. A consultation for family members is meant to help you understand what is happening and choose the right approach, not to diagnose an illness in absentia.
How can I persuade a loved one to see a psychiatrist?
Talk about the specific changes you have noticed and about your own feelings, without labels. Suggest an anonymous online consultation—for many people, this is psychologically easier than a clinic visit. The doctor will help you prepare the conversation with your loved one’s particular traits in mind.
Can a person be hospitalized without their consent?
Only in the cases and under the procedure established by Kazakhstan law: for example, when there is an immediate danger to themselves or others, or when their condition is so severe that significant harm to their health will result without help. The decision is made by doctors and a court, not by relatives.
Can we join the consultation from different locations?
Yes, this is one of the advantages of the online format. Family members can join from different districts—for example, from the right and left banks—or from other cities. What matters is that everyone has a stable connection and can talk without other people present.
What should we do if the situation gets worse at night?
In the event of aggression, a threat to life, a self-harm attempt, or confusion, call 103 or 112 immediately. If there is no danger to life but you are worried, you can contact the Psychiatry Online on-call psychiatrist, who will help you assess whether urgent care is needed.
Do family members need help themselves?
Often, yes. Long-term caregiving for someone with a mental health disorder or an addiction raises the risk of anxiety, depression, and burnout—especially during the long winter, when the family spends more time indoors together. The doctor may recommend psychotherapy or a support group and, if there are signs of a disorder, a separate consultation for you.
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
