Reviewed byAndrey Vetrov, MDPsychiatrist · updated 11.11.2026
Key facts
- ICD-10 code
- F20
- Who provides care
- a psychiatrist; when indicated, a psychotherapist, a psychologist for neuropsychological testing, and a family counselor join the team
- Format
- in-person appointments at our clinic in Almaty, psychiatrist home visits, and online follow-up between in-person visits
- Duration
- initial assessment takes 1.5–2 hours, finding the right therapy takes 4 to 12 weeks, and maintenance treatment continues for years
- Confidentiality
- medical confidentiality under the Code of the Republic of Kazakhstan “On Public Health and the Healthcare System”; anonymous, with no entry in the state psychoneurological dispensary (PND) registry
- When it’s urgent
- threats to harm oneself or others, refusal of food and water, “voices” commanding the person to cause harm — call 103 or 112
- Outcome
- stable remission, fewer hospitalizations, a return to school or work, and a clear family action plan for the first signs of relapse
What to know
Most people in Almaty come to us not at the peak of the illness, but afterward: a person has just been discharged from the hospital, the family has no idea how to go on, and the wait for the district psychiatrist stretches into weeks. Or the opposite: a university student living in a dorm in the Bostandyk district has barely left his room for six months, has dropped out of classes, and says strange things, while his family back in the region can’t tell whether this is an illness or he’s “just burned out.” Either situation is a good reason for a calm, unhurried, in-person assessment by a psychiatrist.
Schizophrenia is a chronic condition, but it is not a life sentence and not “the end of a normal life.” According to WHO and NICE guidance, the key to a good outcome is starting treatment early, staying on maintenance therapy, and working with loved ones. Many of our patients study, work in IT and the service industry, and take their kids to school. A doctor’s job is not only to relieve symptoms, but to find a regimen a person can actually live and work with, and won’t abandon after a month because of drowsiness or weight gain.
When to have a loved one seen by a psychiatrist
- over the past few months, their social circle has shrunk dramatically and they’ve stopped leaving the house
- unusual suspiciousness has appeared: being followed, the phone being “tapped,” the neighbors being “against them”
- their speech has become strange: broken-off thoughts, made-up words, answers that don’t fit the question
- they say they hear voices or feel influenced by some outside force
- they’ve lost interest in school, work, appearance, or hygiene for no obvious reason
- after hospital discharge, the medication was “forgotten” and the old strange behavior has returned
- their sleep is reversed — active at night, asleep during the day — and their conversations contain disturbing ideas
If life is at risk — loss of consciousness, seizures, hallucinations, overdose, suicidal thoughts — call 103 or 112. Helpline for children and young people: 150.
Why schizophrenia develops and what triggers relapses
There is no single cause. Modern psychiatry views schizophrenia as the result of a combination of inherited vulnerability, features of brain development, and external factors. The risk is higher if a close relative has had the illness, but most people who develop it have no such family history. Onset most often falls between the ages of 18 and 30 — the years of university, moving to a big city, and a first job, when stress and lack of sleep pile on top of an existing vulnerability.
In practice, relapses are most often triggered by three things: stopping medication on one’s own (“I feel better now”), using cannabis or other psychoactive substances, and severe stress combined with chronic sleep deprivation. In Almaty we regularly see relapses after exam season, a job change, or conflicts at home. Importantly, neither upbringing nor a “weak character” causes the illness — parental guilt gets in the way of treatment far more than it helps.
How treatment with a Akalam psychiatrist works
The first step can be taken online: relatives describe the history over video, send discharge summaries and a list of medications, and the doctor decides whether a home visit is needed or a clinic appointment is enough. In person, the psychiatrist talks with the patient and family, evaluates mental status, and, if needed, orders blood tests, an ECG, an EEG, or an MRI to rule out other causes. Treatment is then selected, a follow-up is scheduled in 1–2 weeks, and both effectiveness and tolerability are assessed.
Schizophrenia is not treated on an outpatient basis if the person is a danger to themselves or others, completely refuses food and water, cannot control their behavior, or is in acute psychosis — these are indications for inpatient care, and if there is a direct threat, call 103 or 112. Involuntary hospitalization is possible only by court order, following the procedure set by the laws of the Republic of Kazakhstan. A diagnosis cannot be made for the first time, and treatment cannot be started, online without an in-person examination.
How we help
Finding the right maintenance therapy
The foundation of treatment is antipsychotic medication, which is selected only by a doctor. We take into account not just symptoms, but what matters to the person: whether they can drive, whether they’ll be drowsy at work, and how the medication affects weight and hormones. If taking pills regularly is difficult, long-acting injectable forms are discussed. The regimen is reviewed at every visit, with no abrupt discontinuation.
Managing side effects
Many people stop treatment not because of the illness itself, but because of side effects: stiffness, restless legs, weight gain, drowsiness. We explain in advance what may happen, arrange monitoring of weight, blood work, and ECG when indicated, and adjust the regimen accordingly. An honest conversation about side effects is the best way to prevent people from quitting medication on their own.
Psychoeducation and a crisis plan
The patient and family learn what the early warning signs of relapse look like in their particular case: insomnia, irritability, returning suspiciousness. Together with the doctor, they draw up a written plan: whom to call, what to do, when to come to the clinic, and when to call 103. This reduces the number of emergency hospitalizations.
Psychotherapy and social recovery
Cognitive behavioral therapy for psychosis (CBTp, recommended by NICE) helps people cope with residual symptoms and anxiety. Family sessions ease tension at home. A psychologist works on attention, memory, and planning, and helps the person return to school or work step by step — without jumping straight into a full workload.
How treatment works
- 01Call or WhatsAppThe administrator and the doctor on duty clarify the situation and tell you what to do right now.
- 02Examination or consultationThe doctor visits your home, sees you at the clinic or joins by video.
- 03Treatment planWe choose the format — at home, inpatient, psychotherapy or rehab — with a clear price.
- 04Ongoing supportYour doctor and psychotherapist stay in touch: follow-ups, family support and relapse prevention.
Myths and facts
MythPeople with schizophrenia are dangerous
FactThe overwhelming majority of people with schizophrenia are not aggressive and are more likely to be victims of violence themselves. The risk of aggression rises when the illness goes untreated and when alcohol or drugs are involved — which is why regular treatment matters for everyone.
MythMedication is only needed during a flare-up
FactInternational guidelines recommend maintenance therapy after an episode of psychosis, because stopping medication sharply increases the risk of relapse. The duration and dose are decided by the doctor, and any reduction is done gradually and under supervision.
MythWith this diagnosis, you can’t study or work
FactIn stable remission, many people study, work, and start families. What matters is well-chosen therapy, a healthy sleep schedule, avoiding psychoactive substances, and a gradual return to responsibilities with support from specialists.
Prices: Schizophrenia treatment
| Schizophrenia treatment | 25 000 ₸ |
| Psychiatrist consultation at the clinic | 15 990 ₸ |
| Psychiatrist home visit | 35 000 ₸ |
| Follow-up visit, treatment adjustment | 12 000 ₸ |
| Phone consultation | free |
Prices are approximate: the doctor confirms the exact cost after the examination, before treatment starts.
Confidential
We do not register patients with state dispensaries or share information with employers. You do not have to give your surname; doctors arrive in unmarked cars. Medical confidentiality is protected by the Code of Kazakhstan “On Public Health and the Healthcare System”.
Clinic addresses
FAQ
Can schizophrenia be diagnosed in a single consultation?
Sometimes a preliminary assessment is possible, but a definitive ICD-10 diagnosis requires observation: the duration of symptoms, how they change over time, and ruling out organic causes and substance effects all matter. This usually takes several appointments and some testing. We do not make a diagnosis based on relatives’ accounts or over video alone.
My loved one refuses to see a psychiatrist. What should I do?
An adult cannot be treated without consent. Relatives should come in first on their own: the doctor will help you figure out how to talk without pressure and can suggest a gentle format — a home visit framed as a visit “to the family,” or an online conversation. If there is a threat to life or danger to others, call 103 or 112.
Will I be put on the registry if I’m treated at Akalam?
No. Paid, anonymous treatment is provided without entry in the state dispensary registry. Your information is protected by medical confidentiality, with exceptions only as provided by the laws of the Republic of Kazakhstan. At the patient’s request, we can issue a medical summary so that treatment can continue at another facility.
Do you take on patients after discharge from a public hospital?
Yes, this is a common request in Almaty. Bring your discharge summary and all prescriptions. The psychiatrist will assess the person’s condition and how well they tolerate their medications, and adjust the regimen if needed so that treatment is sustainable. Do not change or stop any prescriptions on your own before the visit.
How often do I need to come in?
While therapy is being adjusted — once every 1–2 weeks, sometimes more often. In stable remission — once every 1–3 months, plus an unscheduled visit at the first signs of relapse. Some follow-up appointments can be held online once the doctor knows the patient well.
Is it okay to drink alcohol with schizophrenia?
Honestly, we advise against it. Alcohol weakens the effect of medication, increases drowsiness and side effects, and raises the risk of depression and relapse. Cannabis and other substances are especially dangerous: they can trigger a new psychotic episode even when therapy is well matched.
Sources and review
Prepared by the Akalam medical editorial team based on:
- ICD-10 and ICD-11: mental and behavioural disorders
- Clinical protocols of the Ministry of Health of Kazakhstan
- Code of Kazakhstan “On Public Health and the Healthcare System”
- WHO: mental health and substance use
- NICE and APA clinical guidelines
This information is for reference and does not replace a doctor's consultation. Editorial policy