a 45 year old man was brought to the ED by the police after being called by neighbors because of loud shouting. The patient and his wife had engaged in a physical altercation, and both are treated for minor injuries. The psychiatric mental health nurse practitioner is called to do a psychiatric evaluation. On review of the ED records, you find that the patient has a 20 year history of bipolar disorder, last hospitalization was 5 years ago, and he reports adherence to his treatment regimen that consist of lithium and risperidone. When you enter the exam room, you observe that the is red-faced, sitting cross legged, and is refusing to answer any questions. Your best response is