Firstly, congtats to you for caring about your loved one with mental illness. My family has totally bailed, except for the ones I had to bail from as they won't seek help for mental illness or addiction (I am fully engaged with my mental health team and am 11 years sober).

I agree with Innerzone that a meds change and overall psych asessment definitely needs to be done. If he won't do it, I would ring his psychiatrist and tell them what is happening. If he gets pissed of at that, don't worry - it's better him alive and well and pissed off at you than the alternative. I have been in the state he is in and truly, the events that unfolded mean that me being alive today is a highly unlikely thing. Then, even in the meantime, if he escalates into imminent self-harm, immediately call an ambulance. Again, better him pissed off than the alternative. Having said all that, you own welfare is in the mix here too and you can only do your best - there are many factors at play that aren't in your power to change and you need to try to have some emotional detachment, even while taking positive actions.