What is happening at Rosebud is all too common throughout Indian Country. American Indian and Alaska Native youth 15 to 24 years old are committing suicide at a rate more than three times the national average for their age group of 13 per 100,000 people, according to the surgeon general. Often, one suicide leads to another. For these youths, suicide has become the second-leading cause of death (after accidents). In the Great Plains, the suicide rate among Indian youth is the worst: 10 times the national average.

Here at Rosebud, when six high school girls were approached at the Boys and Girls Club one recent afternoon for their reactions to the suicides, four said they had tried suicide. The four compared notes on their methods — two slashed their wrists, two overdosed on pills — and their motives. “There are a lot of reasons,” said Areina Young, a 16-year-old cheerleader at Todd County High who overdosed on sleeping pills and codeine in February. “We have a lot of issues.”

Plains reservations are among the poorest places in the country, with all of poverty’s consequences. But the why of the suicide phenomenon — why American Indian youth, why the Great Plains — is complicated, experts say. The traumas Plains tribes have experienced over the last 175 years — massacres like the one at Wounded Knee, the decimation of their land and culture — are part of it.

“Very generally, adolescence is a time of trouble for all youths,” said Philip May, a professor of sociology at the University of New Mexico who has been studying suicide among American Indians for more than 35 years. “But in many American Indian communities, it’s compounded by limited opportunities, historical trauma and contemporary discrimination. The way the Lakota people and other Plains tribes have experienced history in the last 100 years has reduced the mental health factors that are available to them to cope.”

Tribal leaders at Rosebud took a survey of Todd County students in March. The students’ biggest complaint was that they did not feel safe for fear of gangs. They said that they had no refuge, that their parents were not present, and that they saw too much tragedy, alcoholism and hopelessness.