Mood disorders: Clinical

A 47-year-old man is brought to the emergency department by his partner for evaluation of erratic behavior. According to the partner, the patient recently lost his job as a software developer. She states, “He’s been drinking so much, I am not sure if he has been doing other drugs too. He spends all day watching television. I recently moved out because of his behavior. I became especially worried this afternoon when I went to check on him, and he told me was going to shoot himself in the head and saw a loaded gun on the kitchen table.” The patient has been previously hospitalized for depression with suicidal ideation. He was treated with fluoxetine but stopped taking the medication several years ago. On evaluation, the patient appears linear and coherent. The patient states, “Doc, I won’t lie. I am feeling pretty hopeless right now, and there is nobody to help me, but I don’t need to be here. My wife is worried for no reason, I’m just going through a rough patch, I’m going to be fine, I promise.” The remainder of the patient’s mental status exam does not demonstrate evidence of hallucinations, delusions, or homicidal ideation. Which of the following is the most appropriate intervention given this patient’s clinical presentation?