A nurse is assisting with the development of a community health education class about suicide prevention. Which of the following information should th nurse identify as risk factors for suicide? (Select all that apply.)

A. Depression is characterized by persistent feelings of sadness, loss of interest or pleasure in activities, changes in sleep and appetite, and difficulties with daily functioning. However, depression alone might not fully explain the abrupt change if there were no prior context of mood swings or manic behavior.
B. Bipolar disorder is marked by extreme mood swings that include manic or hypomanic episodes and depressive episodes. The observed behaviors—active participation and high energy followed by a
sudden shift to tearfulness and withdrawal—are consistent with the mood cycling seen in bipolar disorder. The manic or hypomanic phase could explain the previous high level of activity, while the depressive phase explains the sudden refusal to engage and withdrawal.
C. Psychotic behavior involves a loss of touch with reality, including hallucinations, delusions, and disorganized thinking. The behaviors described (active participation and then sudden withdrawal) do not specifically indicate psychosis.
D. Dysthymic disorder (now referred to as Persistent Depressive Disorder in the DSM-5) is characterized by a chronic, mild depression lasting for at least two years. It typically involves a more consistent, persistent low mood rather than the abrupt shifts seen in bipolar disorder.

The NHS provides comprehensive health care services to all residents, which includes hospital, physician, and mental health care. It is primarily funded through general taxation, ensuring that such services are largely free at the point of use for individuals residing in England. This system emphasizes the right to access care without discrimination and within certain time limits for categories like emergency and planned hospital care. For those "ordinarily resident" in England, this includes a standard benefit package that covers most health care needs, with certain exceptions like some aspects of dental and eye care.