We present a case report highlighting the central role of psychiatrist in care coordination in spite of current trends when care is fragmented and provided by specialist teams. The importance of organic causation in bio-psycho-social case formulation and its treatment is emphasized.

To demonstrate the range of skills employed by practicing psychiatrist in optimising the care of the patients.

The role of Psychiatrists in managing risk in the suicidal patient with depressive illness is paramount and central.

The highlights in a patient’s journey are revisited via a review of medical notes.

The opinions of allied professionals and the split in the team in addressing heightened suicide risk is highlighted. The emphasis is placed on reflecting on when to end active management and consider a maintenance postion for the patient.

The concept of continuity of care and specialist knowledge of person in enhancing quality of care and optimising the patient outcome is firmly established.