Reviewed by: Pavel Kornilov, MD, psychiatrist · updated 6 Nov 2026
Key facts
- ICD-10 code
- F20
- Who leads care
- A psychiatrist experienced in managing psychotic disorders
- Format
- Regular video consultations with the patient and separate sessions with the family
- Duration
- Appointments of 30–50 minutes, care over months and years
- Anonymity
- Medical confidentiality under Kazakhstan law; no data is shared with employers
- When it's urgent
- Aggression, refusing food and water, a threat to self or others — 103 or 112
- Outcome
- Stable remission, fewer relapses and a clear action plan for the family
What you should know
Why does regular follow-up matter so much in schizophrenia? The illness runs in waves: periods of stability alternate with relapses, and a relapse most often begins with barely noticeable changes — disturbed sleep, suspiciousness, refusing medication. Clinical guidelines stress that continuous maintenance treatment and ongoing contact with a doctor reduce the risk of relapse and hospitalization. The video format makes this contact realistic even when leaving the house is difficult.
Online care at Psychiatry Online is designed for people with an established diagnosis and for their families. The doctor assesses mental state, tolerance of treatment, sleep, weight and everyday activity, and helps the family understand what is happening. For a patient in Saryarka or Baikonur district who struggles to get to the dispensary in the January frost and wind, a regular video meeting is a way not to miss follow-up. A first diagnosis of psychosis is not made online: it requires an in-person examination.
Warning signs you should not ignore
- voices or sounds that others do not hear, commenting on the person's actions
- a firm belief in being watched or persecuted, or that ordinary events carry special meaning
- speech becomes incoherent, thoughts “break off” or get tangled
- withdrawal from social contact, loss of interest in work, studies and loved ones
- emotions become “flat,” facial expressions sparse, answers monosyllabic
- disturbed sleep and daily rhythm, activity at night, anxiety for no reason
- refusing treatment, being convinced that medication is “harmful” or “poisonous”
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 is known about the causes of schizophrenia
Schizophrenia is an illness with a strong biological component. Heredity raises the risk but does not predetermine it: what matters is the combination of genes and environmental factors. Research links the symptoms to dysfunction of the brain's dopamine and glutamate systems. This is why antipsychotics are the foundation of treatment: they reduce the excessive dopamine activity associated with delusions and hallucinations.
Relapse is triggered by stress, lack of sleep, use of psychoactive substances — especially cannabis — and stopping treatment. In winter, short daylight hours and isolation are added to this: a person goes out less, talks to people less, and early signs of deterioration are easy to miss. The purpose of long-term care is to notice these signals in time and adjust treatment before a relapse fully develops.
How online care for a patient is organized
During a video appointment, the doctor talks with the patient and assesses speech, thinking, mood, the presence of positive symptoms, sleep and appetite. They discuss how the treatment is being tolerated: whether there is stiffness, restlessness, weight gain or drowsiness. With the patient's consent, a relative can join the conversation. Have a list of current medications, discharge summaries and test results ready. Join from a room where no one will disturb you — a sense of safety is important for the patient.
Online care is not suitable for making an initial diagnosis, assessing acute psychosis or situations where life is at risk. In case of aggression, suicidal statements or refusal to eat, call 103 or 112. Blood tests, ECGs and weight checks are done in person at a laboratory. Hospitalization, including involuntary hospitalization, is possible only in the manner established by the law of the Republic of Kazakhstan.
How we help
Maintenance antipsychotic treatment
According to international guidelines, the foundation of treatment is long-term antipsychotic medication. The doctor assesses effectiveness and side effects and, if necessary, discusses switching to another drug within the class or moving to long-acting injectable forms. Doses and regimens are tailored individually and only by a doctor; treatment must never be stopped on your own.
Family work
Family interventions are one of the best-proven ways to reduce relapse. Relatives learn how to recognize early signs of deterioration, how to talk to their loved one without conflict and what to do in a crisis. Online sessions are convenient: family members can join from different parts of the city or even from different cities.
Relapse prevention plan
Together with the patient and their family, the doctor draws up a written plan: what this particular person's early warning signs are, whom to call, what steps to take and when to call an ambulance. Such a plan reduces panic at a critical moment and helps everyone act quickly. It is reviewed at each stage of care and kept where the family can find it fast.
Psychosocial rehabilitation
Cognitive behavioral therapy for psychosis, social skills training and help returning to work or studies improve quality of life. Some of these sessions are held online, which lowers the barrier: there is no need to travel to the city center through traffic jams and frost — a stable connection and a quiet place for the session are enough.
Myths and facts
MythSchizophrenia means a split personality
FactThese are different conditions. Schizophrenia involves disturbances of thinking and perception: delusions, hallucinations, reduced motivation. Dissociative identity disorder is a separate diagnosis. The confusion is fueled by movies and deepens stigma.
MythPeople with schizophrenia are dangerous
FactMost patients are not aggressive, and they are actually more likely to become victims of violence themselves. The risk of aggression rises when there is no treatment and when substances are used. Regular follow-up and treatment reduce this risk significantly.
MythOnce you feel better, you can stop the medication
FactStopping medication on your own is one of the main causes of relapse. Feeling better means the treatment is working. Any changes to treatment are discussed with the doctor and made gradually, under supervision.
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
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
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
Can schizophrenia be diagnosed online?
An initial diagnosis is not made online: it requires an in-person examination, a detailed history, sometimes tests and ruling out other causes. The online format is suitable for a second opinion based on existing records, long-term care and family consultations. The doctor will advise where to go for an in-person diagnostic assessment.
How often are consultations needed during ongoing care?
While treatment is being selected or changed — every 1–2 weeks; in stable remission — once a month or less often. The frequency is set by the doctor based on the patient's condition. The video format means you don't miss appointments even in severe frost, when getting from the Right Bank to the Left Bank of the city is difficult.
Can a relative get a consultation without the patient?
Yes. The family can get advice on how to behave with their loved one, how to recognize deterioration and how to persuade the person to seek help. Without the patient's consent the doctor may not discuss specific medical information about them, but will give general recommendations.
What should we do if the person refuses treatment?
Start with a calm conversation without pressure, looking for what matters to the person themselves: sleep, work, relationships. An online doctor will help the family plan this conversation. If there is a threat to life, call 103 or 112. Involuntary hospitalization is possible only on the grounds established by the law of the Republic of Kazakhstan.
How are treatment side effects monitored?
The doctor asks about stiffness, restlessness, drowsiness, changes in weight and menstrual cycle, and orders blood tests and an ECG, which are done in person. You can show the results at an online appointment. If side effects are significant, adjustments within the medication class are discussed.
Is anonymity preserved during long-term care?
Yes. Information about diagnosis and treatment is protected by medical confidentiality under the Kazakhstan Code “On Public Health and the Healthcare System.” Employers and outsiders do not receive it. The only exceptions are cases expressly provided for by law, such as a court request or a threat to life.
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
