Reviewed byTimur Abdrakhmanov, MDPsychotherapist · updated 11.11.2026
Key facts
- ICD-10 code
- F43
- Who provides it
- A psychotherapist or clinical psychologist experienced in crisis work; a psychiatrist when needed
- Format
- An in-person session in Almaty or Astana, video or phone for other cities; consultations for relatives
- Duration
- The first session lasts 60–90 minutes, followed by 1–5 sessions over 2–6 weeks
- Confidentiality
- Medical confidentiality; the only exceptions are a direct threat to life and cases provided for by the laws of the Republic of Kazakhstan
- When it is urgent
- Suicidal thoughts or a suicide plan, self-harm, or a threat of violence: call 112; for children and young people, call 150; for psychosis, call 103
- Outcome
- Stabilization, a safety plan, restored sleep and ability to function, and clarity on whether further help is needed
What to know
First, the most important thing. If you or someone close to you is having thoughts of suicide or an intention to self-harm right now, or someone is in danger, do not wait for an appointment: call 112. Children, teenagers, and young people can get help from the free 150 helpline. We work alongside the emergency services but do not replace them. A crisis psychologist cannot arrive within minutes like an ambulance, and cannot stop someone from taking a dangerous step from a distance.
Crisis support is needed when something has happened that no one can prepare for, and the usual ways of coping have stopped working. A person may be unable to sleep or eat, may cry nonstop, or, on the contrary, may feel nothing at all. This is a normal reaction to an abnormal event. This page covers the first days and weeks after such an event. Long-term work with anxiety, depression, or the aftermath of trauma is described in our other sections on psychotherapy and psychiatry.
Signs That Someone Needs Crisis Support
- several days have passed since the event, yet the person is barely sleeping or eating
- scenes of what happened keep replaying, with flashbacks and nightmares
- a sense of unreality or numbness, as if everything is happening to someone else
- sudden bouts of panic, crying, or anger that are hard to stop
- the person cannot manage simple tasks: getting up, making a phone call, handling everyday matters
- thoughts have appeared such as “it would be better if I weren’t here” or “I see no point in going on”
- use of alcohol or sedatives has risen sharply in order to “switch off”
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 Happens to the Mind in a Crisis
A crisis arises when an event exceeds a person’s ability to cope with it. The nervous system switches into alarm mode: the heart beats faster, sleep is disrupted, attention narrows, and decisions become hard to make. In ICD-10, acute stress reaction belongs to category F43 and usually subsides within hours or days if the person is safe and receives support. It is not an illness in the usual sense but the body’s response to overload.
Long-lasting consequences are more likely if the event involved a threat to life or violence, or if the person was left without support, has experienced trauma before, or has depression or an addiction. The WHO guidance on psychological first aid emphasizes that in the first days, a deep exploration of what happened matters less than safety, calm, connection with loved ones, and practical help. That is exactly where our work begins.
How Crisis Support Works: The First Session and the Days After
When you call, our administrator first checks whether there is a direct threat to life; if there is, they refer you to 112. The first session is scheduled as soon as possible. The psychotherapist listens without pressure, helps you calm down, assesses the risks, and works with you to draw up a safety plan: who is nearby, whom to call, and what to do at night if things get worse. Sleep, food, and tasks for the coming days are discussed. This is followed by 1–5 sessions, online or in person, over several weeks.
A crisis psychologist cannot provide round-the-clock supervision. If a person has a suicide plan, cannot promise to keep themselves safe, or has begun hearing voices, or shows delusions, severe confusion, or aggression, emergency medical care is needed: call 103 or 112. In cases of violence, call the police at 102. In such situations, an examination by a psychiatrist and inpatient care may be required; involuntary hospitalization is possible only in accordance with the procedure established by the laws of the Republic of Kazakhstan.
How we help
Psychological first aid
An approach described in the WHO guide: look, listen, link. The specialist finds out what the person needs right now, provides a sense of safety, and helps them get in touch with loved ones and obtain practical help, for example with paperwork or funeral arrangements. No one is made to describe the details of the event if they are not ready.
Safety plan
A written plan that you draw up together with the psychotherapist: which signs show that things are getting worse, what helps you calm down, whom you can turn to, how to remove access to dangerous objects and medications, and which numbers to dial: 112 and 150. You and a trusted person both keep a copy. This is one of the recommended tools for suicidal thoughts.
Stabilization and self-regulation techniques
Simple exercises that restore a sense of control: breathing with a longer exhale, grounding through the senses, a regular sleep and meal routine, and small scheduled tasks. The psychotherapist teaches them during the session and gives you a handout. They do not take away grief or fear, but they help you get through the most acute hours and fall asleep, even if only for a while.
Assessment and referral for further care
Toward the end of the crisis course, we assess together how you are coping. For most people, acute reactions gradually subside. If nightmares, avoidance, low mood, or alcohol dependence persist after a month, the psychotherapist will recommend a course of trauma-focused therapy or a consultation with a psychiatrist or an addiction physician. The decision is yours.
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 need to describe everything that happened in detail right away
FactBeing pushed into a detailed account in the first days can increase suffering. WHO and NICE guidance advise against offering this kind of “debriefing” to everyone. The specialist follows the person’s lead: some need to talk it all out, while others simply need to sleep and feel that they are not alone.
MythIf someone talks about suicide, they won’t actually do it
FactThis is a dangerous misconception. Any talk of death must be taken seriously. Ask directly whether they are having thoughts of suicide and whether they have a plan, do not leave them alone, remove dangerous objects, and call 112. Asking directly does not push someone toward suicide; it gives them a chance to ask for help.
MythA strong reaction to tragedy is a sign of mental illness
FactInsomnia, tears, numbness, and anxiety after a devastating event are a normal reaction. In most people, they ease within a few weeks with support. It is worth seeing a psychiatrist if your condition does not improve, gets worse, or interferes with your life.
Prices: Crisis psychological support
| Crisis psychological support | 15 000 ₸ |
| Psychotherapist session (50 min) | 14 990 ₸ |
| Psychologist session (50 min) | 12 000 ₸ |
| Family session (80 min) | 25 000 ₸ |
| 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
How quickly can I get crisis support?
We try to schedule the first session as soon as possible; online, it is often the same day or the next. But if the situation is life-threatening, you must not wait: call 112. The 150 helpline answers children and young people around the clock. We can step in once emergency care has already been provided.
Can I seek help on behalf of a loved one who doesn’t want it?
Yes, consultations for relatives are a common form of crisis support. The specialist will advise you on how to talk to your loved one, which danger signs to watch for, and how to offer support without overloading yourself. If an adult refuses help and there is a threat to life, call 112.
How is crisis support different from regular psychotherapy?
Crisis support is short-term and focused on the days immediately ahead: safety, sleep, basic needs, and support. In-depth work on trauma, childhood, or relationships is not done at this stage. If longer-term work is needed after the crisis, the psychotherapist will suggest a suitable course.
Is medication needed in a crisis?
In most cases, no: in the first days, support, routine, and self-regulation techniques help more. If insomnia, panic, or low mood are severe and are not easing, the psychotherapist will recommend a consultation with a psychiatrist. Medication is prescribed only by a doctor after an examination, and you should not take sedatives on your own.
Can I get help if I live in a small town?
Yes. Akalam psychotherapists hold crisis consultations by video and phone for any city in Kazakhstan. We confirm your address and a loved one’s contact details in advance so that local emergency services can be called if needed. In-person sessions are held in Almaty and Astana.
What should I do if things get really bad at night?
Follow your safety plan: call your trusted person and use the techniques that have helped before. If suicidal thoughts grow stronger or you develop an intention to act on them, call 112 immediately. Children and teenagers can call 150. Do not stay alone, and do not take alcohol or any medication that has not been prescribed.
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