Reviewed byAndrey Vetrov, MDPsychiatrist · updated 11.11.2026
Key facts
- ICD-10 code
- F23
- Who provides care
- the on-call psychiatrist; if a physical cause or intoxication is suspected — together with ambulance doctors and the appropriate specialist hospital
- Format
- phone consultation 24/7, psychiatrist home visits in Almaty, Astana and other cities, inpatient care when needed; online support is for the family only
- Duration
- home visit and assessment — 1–2 hours; with treatment, an acute episode usually subsides within days or weeks, followed by months of follow-up
- Confidentiality
- medical confidentiality, anonymous care, no entry in the state registry; exceptions only as provided for by the law of the Republic of Kazakhstan
- When it is urgent
- aggression, threats, attempts at self-harm, weapons in the home, confusion with high fever, seizures — call 103 or 112 immediately
- Outcome
- the person is safe, the cause of the psychosis has been identified, treatment has started, and the family has a clear plan for the coming weeks
What to know
This page is for people who can see right now that something frightening is happening to someone close to them: they are saying strange things, do not recognize their surroundings, hear voices, have not slept for several nights, and may be agitated or, on the contrary, frozen. In the first minutes, what matters most is safety, not working out the cause. If there are weapons, knives, open windows, or threats to harm themselves or others, call 103 or 112 immediately. If there is no danger, call us: the on-call psychiatrist will help you decide what to do next.
Psychosis is not a diagnosis but a syndrome, and its causes vary widely. It can be the first sign of schizophrenia or bipolar disorder, but it can also result from substance use, alcohol withdrawal, high fever, infection, head injury, hormonal disorders or medication side effects. That is why, in an acute state, the doctor does more than calm the person down — they also look for a physical (medical) cause, because that determines where the person should go: to psychiatric care, a toxicology unit or a general hospital.
Signs of acute psychosis that should not wait
- the person answers voices, listens intently to something, or talks to an invisible companion
- they have become convinced they are being followed, poisoned or targeted by a conspiracy
- they have not slept for two or three nights in a row and yet do not feel tired
- their speech is incoherent, they do not understand where they are, or they do not recognize loved ones
- sudden agitation, shouting, attempts to run away or barricade themselves in
- freezing in one position, refusing to answer, eat or drink
- strange behavior during a high fever or after stopping alcohol or drugs
If life is at risk — loss of consciousness, seizures, hallucinations, overdose, suicidal thoughts — call 103 or 112. Helpline for children and young people: 150.
What causes psychosis and why finding the cause matters
Mental health causes include acute and transient psychotic disorders (F23 in ICD-10), the onset of schizophrenia, manic or depressive episodes with psychotic features, and severe stress. Acute and transient psychotic disorder starts quickly, over a few days, and with timely treatment it can resolve completely. However, in the first days it is impossible to tell it apart from the start of a chronic illness, so follow-up is needed even after improvement.
External causes are just as common: intoxication with psychoactive substances, alcohol withdrawal delirium (delirium tremens) after suddenly stopping drinking, severe infections, dehydration, low blood sugar in people with diabetes, injuries, tumors, the postpartum period and certain medications. In older people, sudden confusion is often linked to a urinary tract infection or pneumonia. This is exactly why the psychiatrist first rules out anything that needs urgent medical care.
How a psychiatrist’s home visit for acute psychosis works
First, the doctor asks a few questions by phone: what is happening, whether there is any danger, whether there is a fever, any alcohol or drug use, chronic illnesses or medications. They advise you how to behave until they arrive: speak calmly, do not argue with the delusions, remove sharp objects and do not leave the person alone. On site, the psychiatrist examines the patient, relieves agitation with the patient’s consent, assesses the risk and decides together with the family whether treatment can continue at home or hospital care is needed.
A person in acute psychosis must not be left at home if they are a danger to themselves or others, are not eating or drinking, or if the psychosis comes with a high fever, seizures, impaired consciousness, or developed during alcohol withdrawal. These are indications for hospital care or for calling 103/112. Involuntary hospitalization is possible only under the procedure established by the law of the Republic of Kazakhstan, by court decision; the clinic does not take anyone away by force.
How we help
Relieving acute agitation
If the person agrees, the doctor prescribes medication to reduce agitation and anxiety — antipsychotics or anxiolytics, strictly when indicated. Words always come first: a calm tone, simple phrases, and an explanation of who has come and why. Many people in psychosis are very frightened, and the feeling of being heard and not judged in itself reduces the tension.
Looking for a physical cause
The psychiatrist measures blood pressure, pulse and temperature, asks about substance and medication use and checks for neurological signs. If an infection, intoxication, injury or delirium is suspected, the person is referred to the appropriate hospital, where they need tests and monitoring that are impossible at home. Psychiatric treatment begins once these causes have been ruled out.
Inpatient treatment
Hospital care is needed when safety and round-the-clock observation cannot be ensured at home. In hospital, the person is assessed, therapy is selected and their response to it is monitored. As a rule, the acute phase lasts from a few days to a few weeks. We help the family choose a suitable facility and stay in touch after discharge.
Follow-up after an episode
After acute psychosis, the risk of recurrence remains, especially in the first months. The psychiatrist continues treatment, gradually clarifies the diagnosis and discusses early warning signs with the family: insomnia, irritability, suspiciousness. It is important not to stop therapy at the first sign of improvement — this is a common mistake that leads to the symptoms coming back.
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
MythYou can talk a person out of psychosis
FactArguing with delusions is pointless and often dangerous: the person experiences it as an attack. It is better to talk about feelings — “I can see you’re scared” — without agreeing or disproving. Beliefs change as treatment works, not after a debate.
MythPsychosis always means schizophrenia
FactNo. Psychosis can be caused by substances, infections, alcohol withdrawal, the postpartum period, stress and other factors. Some episodes resolve completely and never come back. A diagnosis is made after a period of observation, not on the first day.
MythJust wait — it will pass on its own
FactWaiting is dangerous: a person in psychosis may harm themselves or stop eating and drinking, and a serious physical condition may be hiding behind the psychosis. The sooner help begins, the faster the episode passes and the better the outlook.
Prices: Help with acute psychosis
| Help with acute psychosis | 40 000 ₸ |
| 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
What should I do while the doctor is on the way?
Stay calm and speak in short sentences. Put away knives, medications and car keys, and close windows and the balcony. Do not argue about what the person is experiencing and do not try to hold them by force. Do not leave them alone. If there is aggression, a weapon, an attempt at self-harm or seizures, call 103 or 112 without waiting for our doctor.
Can acute psychosis be treated at home?
Sometimes, yes — if there is no danger, the person accepts treatment, relatives are ready to be with them around the clock, and the doctor has ruled out physical causes. In all other cases, hospital care is safer. The psychiatrist makes this decision after an in-person assessment, not over the phone, and reviews it if the person’s condition changes.
Our loved one refuses to see a doctor. What can we do?
An adult cannot be treated without consent, except in cases provided for by the law of the Republic of Kazakhstan — by court decision. If there is a direct threat to life, call 103 or 112: emergency services act according to their own procedures. If there is no threat, try offering help with sleep or anxiety — people in psychosis agree to this more often than to seeing “a psychiatrist.”
How long does acute psychosis last?
It depends on the cause. Psychosis caused by intoxication or fever may pass within a few days once the cause is removed. Acute and transient psychotic disorder usually subsides within a few weeks with treatment. The onset of a chronic illness requires a longer period of treatment selection and follow-up.
Will my employer find out about the psychosis?
No, unless you tell them yourself. Akalam observes medical confidentiality, and treatment is provided anonymously, without registration on any state registry. A sick-leave certificate is issued only at your request, and information about the diagnosis is shared with third parties only in cases expressly provided for by the legislation of the Republic of Kazakhstan.
Will the psychosis come back?
That depends on the cause and on how consistently treatment is followed. After an episode linked to substances, the main prevention is giving them up completely. After an acute psychotic disorder, the doctor recommends maintenance therapy for an individually determined period and regular check-ups in the first months.
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