On the Spirit Lake Nation in North Dakota years ago, a 14-year-old girl named Avis Little Wind hanged herself after lying in bed in a fetal position for 90 days. Her death followed the suicides of her father and sister.

“She lay in bed for all that time, and nobody, not even her school, missed her,” said Dorgan, a Democrat who chaired the Senate Committee on Indian Affairs. “Eventually she got out of bed and killed herself. Avis Little Wind died of suicide because mental-health treatment wasn’t available on that reservation.”