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A 44-year-old man attends the community mental health clinic. He has recurrent major depressive disorder and came home nine days ago after a two-week admission to the mental health unit. He lives alone since his marriage ended two years ago, has chronic low back pain for which he takes tramadol, drinks six standard drinks most Friday and Saturday nights, and his father took his own life when he was fourteen. He denies any current plan and says he is getting there. Which one of the following carries the greatest weight in his risk of suicide over the next fortnight?
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