A 62-year-old patient with a diagnosis of an unspecified mood disorder arrives for an outpatient mental health
A 62-year-old patient with a diagnosis of an unspecified mood disorder arrives for an outpatient mental health appointment. The patient was recently discharged from an inpatient facility after an intentional medication overdose. They agreed to outpatient follow-up as part of the discharge plan. The patient is accompanied by their spouse. The patient does not respond to questions and stares intensely at the nurse practitioner throughout the interview. The spouse explains that, for as long as they can remember, the patient has struggled with long periods of depressed mood, hypersomnolence, diminished concentration, and hopelessness but also periods of prolonged irritability, impulsive behaviors, high energy with minimal sleep, and rapid speech. When the nurse practitioner asks about the hospitalization, the patient begins yelling that the hospital billed thousands of dollars and did nothing for them. They tell the nurse practitioner that being in the appointment today is another waste of time and money and ask whether they can leave. What is the nurse practitioner’s best response?
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