A 19-year-old male college student was started on escitalopram 10 mg daily two weeks ago for major depressive disorder. At his two-week follow-up, he reports feeling somewhat more energized and less fatigued, and his sleep has improved. His PHQ-9 score has decreased from 19 to 14. However, during the interview he discloses new onset of racing thoughts, increased irritability, and fleeting thoughts of self-harm that he describes as intrusive and ego-dystonic. He denies any plan or intent and states the thoughts are distressing to him. He had no suicidal ideation at baseline or at any previous point in his life. He denies access to lethal means and has supportive roommates. The PMHNP is evaluating these new symptoms in the context of early antidepressant treatment. Which evaluation is most clinically appropriate?