Reviewed by: Assel Omarova, MD, psychiatrist and addiction specialist · updated 6 Nov 2026
Key facts
- Who leads the session
- a dedicated psychiatrist, working together with a psychotherapist and an addiction specialist when needed
- Format
- scheduled video consultations, with messaging contact between them on agreed-upon issues
- Duration
- 30–40-minute appointments every 2–6 weeks; ongoing care lasts from several months to several years
- Anonymity
- follow-up under a code identifier; medical confidentiality under Kazakhstan law
- When it is urgent
- suicidal thoughts, signs of mania or psychosis—call 103 or 112, then let your doctor know
- Outcome
- lasting remission, timely treatment adjustments, and a personal relapse prevention plan
What you should know
Why is a single consultation not enough for many disorders? Depression, anxiety disorders, and bipolar disorder often follow a recurrent course: after a first episode, the risk of another is significantly higher than in the general population, and it grows with each new episode. That is why clinical guidelines emphasize not only treating the acute phase but also the maintenance phase—systematic follow-up that makes it possible to notice early warning signs of deterioration.
The most vulnerable part of this kind of follow-up is keeping it regular. When you have to travel to see a doctor, appointments get rescheduled and then stop altogether as soon as you feel better. Online follow-up removes this barrier: 30 minutes from home or your office at work, without a trip through the frost and wind and without traffic jams on the bridges between the right and left banks. The doctor knows your history, sees your progress, and responds before a deterioration turns into a full-blown episode.
Who Needs Regular Psychiatric Follow-Up
- you have had one or more episodes of depression and want to prevent another
- you have been diagnosed with bipolar disorder and need monitoring of mood phases
- you take medications that require regular assessment of their effect and lab tests
- your anxiety disorder or obsessive-compulsive disorder comes and goes in waves
- you need maintenance treatment after being discharged from the hospital
- a period of increased pressure lies ahead: exams, reporting season, a move, childbirth
- you plan to gradually stop your medications under a doctor’s supervision
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 Relapses Happen and How to Prevent Them
A relapse rarely comes out of nowhere. It is usually preceded by prodromal signs—changes in sleep, lower energy or, conversely, racing thoughts, irritability, and giving up usual activities. These are easy to mistake for ordinary fatigue. The mechanism is explained by the stress–vulnerability model: each episode lowers the threshold at which stress triggers the next one, which is why early intervention is so important.
Common triggers include stopping medication on your own, disrupted sleep, alcohol use, chronic stress at work, and seasonal changes. In a region with long winters and short daylight hours, seasonality is especially noticeable: for some people, deterioration predictably falls between November and February. Regular follow-up makes it possible to prepare for these periods in advance and adjust the plan in time.
How Ongoing Online Psychiatric Care Works
At the first appointment, the doctor builds a complete picture: your diagnosis, history of episodes, current treatment, and individual triggers. Together, you create a plan: how often to meet, which rating scales to use for monitoring, your personal early warning signs, and what to do when they appear. After that, each appointment is an assessment of your condition, sleep, how well you are tolerating treatment, and events since the last visit. You can keep a mood diary in an app and show it to your doctor.
Online follow-up does not replace lab monitoring, an ECG, or an in-person examination if these are required for your prescribed treatment: the doctor will give you referrals. Prescribing certain prescription medications depends on Kazakhstan law. In an acute deterioration—a psychotic episode, mania, or suicidal intent—in-person care, a home visit by a doctor, or inpatient treatment will be needed; if there is a threat to life, call 103 or 112.
How we help
Personal relapse prevention plan
Together with your doctor, you identify your own “early warning signals”—for example, sleeping two hours less, canceling plans with people, or spending more money—and specific actions: contact the doctor, adjust your routine, change your workload. A plan like this is one of the most evidence-based tools for preventing relapse in depression and bipolar disorder.
Treatment monitoring
The doctor regularly assesses how effective and well tolerated your treatment is, watches for side effects, orders the necessary lab tests, and adjusts the regimen in time. This is especially important for mood stabilizers and certain antipsychotics, which require lab monitoring. When discontinuation is appropriate, it is done gradually, on an agreed schedule and under supervision.
Lifestyle work
Sleep problems, lack of light and physical activity, alcohol, and overload are modifiable risk factors for relapse. The doctor helps you build a sustainable routine that fits your real schedule, including irregular hours in government service. For seasonal deterioration, preventive measures are discussed in advance, before the dark season begins.
Team-based care
When needed, a Psychiatry Online psychotherapist and addiction specialist join your care. Psychotherapy focused on relapse prevention—such as cognitive behavioral therapy or mindfulness-based therapy—complements medication. All specialists see the shared plan and coordinate their decisions, so you do not have to retell your story over and over.
Myths and facts
MythOnce you feel better, you can stop follow-up
FactImprovement is the beginning of the maintenance phase, not its end. The risk of relapse is highest in the first months after remission, and regular appointments help you hold on to the progress you have made.
MythRegular follow-up means being put on a registry
FactVoluntary follow-up with a doctor, including online, is not the same as being placed on the dispensary registry. Information about your health is protected by medical confidentiality and is disclosed only in cases provided for by Kazakhstan law.
MythOnline follow-up is only suitable for mild cases
FactOnline care is also used for bipolar disorder and recurrent depression when the condition is stable. If symptoms flare up, the doctor switches to in-person care or arranges hospitalization without interrupting follow-up.
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
You can book in Astana online or at one of two branches: 72 Bogenbay batyra St., Astana, 37 Petrova St., office 23, Astana. Our coordinator replies on WhatsApp within minutes at any time, and a doctor usually connects by video the same day; home visits are available too — all city districts and nearby settlements.
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
How often are appointments needed?
While treatment is being adjusted, every 2–4 weeks; when you are stable, every 4–6 weeks. The frequency is set individually and can change: before known difficult periods, such as the start of winter or reporting season, appointments can be scheduled more often.
Can I message my doctor between appointments?
Yes, on agreed-upon issues: side effects, early signs of deterioration, and questions about your regimen. Messaging does not replace a consultation, and for complex questions the doctor will suggest an extra appointment. In an emergency, call 103 or 112.
What happens if I move to another city?
Online care continues without any changes: the format does not depend on where you live. If in-person steps are needed—lab tests or an examination—the doctor will advise you on how to arrange them in your new location and help connect you with local specialists.
How long does ongoing care last?
It depends on the diagnosis and the history of episodes. After a first episode of depression, it usually lasts several months after remission; for recurrent depression and bipolar disorder, longer—sometimes years. The decision to end care is made together, gradually, and with a plan for the future.
Will this work with a busy work schedule?
Yes—this is one of the main reasons people choose the online format. Patients from the Yesil and Almaty districts often schedule appointments for early morning or late evening. A short appointment does not require taking time off, and follow-up continues even during your busiest months.
Can I switch to ongoing care after treatment at another clinic?
Yes. Send us your discharge summaries and a list of your medications—a Psychiatry Online doctor will review them, hold an initial consultation, and put together a maintenance treatment plan. This is a common scenario after hospital discharge or a move, and it does not require repeating all your tests from scratch.
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
