Workers say girl’s death is an example of what they feared from Providence closing the unit
A 12-year-old girl died by suicide this month after workers say she was left unsupervised at Providence Sacred Heart Medical Center, where she was waiting for a long-term psychiatric placement.
Sarah June Niyimbona, who had been receiving intermittent psychiatric care for self-harm and suicide attempts at the hospital over the last eight months, slipped out of her room without triggering the alarm and left the pediatric floor alone around 5:30 p.m. on April 13, according to a family member and three employees involved in her care. She then walked a quarter mile to the fourth floor of a parking structure on the hospital campus and jumped, dying two hours later in the emergency room.
"We're confused how this could happen," Sarah’s sister Asha Joseph said. "We also want to know why there wasn't anyone there at the moment, why there was nobody watching her and how she was able to leave. We don't really know anything. We don't have any of the answers."
Spokane's Providence Sacred Heart has not released any information about Sarah’s death to the public. In response to InvestigateWest's request for an interview, Providence spokeswoman Beth Hegde sent a statement by email: “We extend our sympathy to the family and loved ones affected by this tragic situation." Providence refused to provide any additional information, citing privacy laws.
Sarah’s death, pieced together through interviews with health care providers and family, 911 calls, and a hospital report submitted to the state’s health department, comes just six months after the hospital closed its Psychiatric Center for Children and Adolescents. That decision was made over the objections of staff and community members concerned about a lack of beds for youth in need of inpatient mental health care. In February 2024, hospital executives wrote in a state grant application that the center, despite losing $2 million a year, provided lifesaving care to children and teens, and that nearby facilities would struggle to fill the gap if it closed. After closing the center, however, Sacred Heart CEO Susan Stacey minimized the impact, saying a for-profit facility in Spokane was ready to meet the demand.
Now, critics of the closure said Sarah’s death is an example of the harm they feared would come from the decision.
“When Sacred Heart closed its adolescent psychiatric unit just months ago, nurses, physicians, community members, and former patients and their families warned about the impact this would have on services for this highly vulnerable population,” said David Keepnews, executive director of the Washington State Nurses Association. “WSNA expressed concern about a decision that was based on the financial bottom line at the expense of the community’s needs.”
“We said this is what was going to happen,” said Kaili Timperley, a former nurse in the children’s psychiatric unit. “We said their plan was not an adequate plan. You can’t just put these kids in a medical room and expect everything to be OK. It’s why we tried to fight against it and get the word out.”
Youth who have threatened or attempted self-harm continue to languish in Sacred Heart’s emergency department and in the general pediatrics floor, where the hospital converted two rooms into new psychiatric beds last fall.
Pediatric staff said those rooms are less equipped than the shuttered psychiatric center to serve children who are flight risks or suicidal. Unlike the psychiatric center that had at least two sets of locked doors, the doors to the general pediatric unit do not lock from the inside, making it easier for a child to leave undetected. And pediatrics staff now tasked with caring for psychiatric patients in the new rooms received no additional training on how to treat and protect these patients, according to a pediatric nurse who requested anonymity due to employment concerns.
That same nurse said staff had repeatedly raised alarms about Sarah’s safety. The girl spent most of her time on the pediatrics floor confined to her room, experiencing almost no peer interactions and less therapeutic care than patients received in the former psychiatric center, members of her care team said.
Staff and Sarah’s family said they are most confounded by the decision to leave her unsupervised. For months, as she continued to make threats and attempts at self-harm, Sarah had had at least one “sitter,” a designated person assigned to monitor her around the clock to make sure she didn’t leave or hurt herself, staff and her sister said. Earlier in her stay, she had had two, including a remote sitter who monitored her through a camera in her room. The camera had been removed a few weeks prior.
Then, in early April, when the girl was writing in her journal that she couldn’t wait to return home, the hospital removed her in-person sitter, too. Days later, she was dead.
As codes relaying the final attempts to save Sarah’s life were announced over the hospital intercom, pediatric nurses stopped trying to care for their patients and sat at the nurses station together and cried.
“That's where this frustration and feeling of helplessness is really coming from,” said a nurse who helped care for Sarah in the pediatric unit. “We did try to speak up. We did try to say, ‘This isn’t safe. We cannot take away the security because she’s going to hurt herself.’”
Joseph, her 19-year-old sister, said Sacred Heart has provided few answers regarding Sarah’s death.
"It felt like, in a way, the hospital is kind of trying to, I don't know, cover up something or hide something," Joseph said. "It just doesn't make sense. There's really no information on anything."
Sacred Heart staff members said they felt intense pressure in the days after Sarah’s death to keep quiet. In a hospital-wide email on the night of her death, employees were instructed to refrain from posting about the incident or commenting on posts about it on social media.
“We know that the hospital is obligated to conduct their own investigation and root cause analysis,” said Keepnews, the nurses union executive director. “But we also think that the family, our members, and the community will need to know what went wrong and to be assured that steps will be taken to prevent a horrific tragedy like this from happening again.”
Isolated in Room 350, Sarah spent the last three months of her life watching "Friends" reruns and writing in her journal that was covered in rainbow drawings. Staff who worked in the unit said Sarah was frustrated and bored. She couldn't change the television channel or draw as often as she liked because the television remote and colored pencils were safety hazards. In her final days after her sitter was removed, an alarm on her door blared down the hall each time she opened it to ask for water, food or to go to the bathroom. One staff member called Sarah’s care dehumanizing.
"These are the people who are supposed to be helping her," Joseph said. "And so hearing from her that these are the people who are making it harder for her was very, very hard for me to just take that in, and I was very angry about that."
Joseph described her sister as sassy and outspoken. The third of six kids, Sarah was great at math, loved to dance and helped with an afterschool program at her little brother's elementary school.
"She was very selfless," Joseph said. "Like, right now, a lot of her friends are reaching out to me and just letting me know how, if they had any trouble in school, Sarah was always the first person to just be there to stand up for them."
Sarah completed her first year of middle school in May and spent much of the summer isolating herself in her room, Joseph said. After being bullied at school and on social media, Sarah became extremely moody and was sad most of the time. The first time she harmed herself, Joseph rode with her in an ambulance from their home in Cheney to the emergency room at Providence Sacred Heart where Sarah was discharged about six hours later. Then it happened again. And again.
"It became frequent for her to leave the house, and then she'd usually call the authorities herself saying she wanted to harm herself," Joseph said. "She'd act really positive and normal, like, 'I'm going for a walk' or 'taking out the trash,' and then we'd get a call saying she was on the way to the hospital."
Sarah was in and out of care. She cycled between the emergency room, Inland Northwest Behavioral Health, Frontier Behavioral Health and a group home called Evangeline's House until January when she was moved to the general pediatric unit at Providence Sacred Heart.
It isn’t clear what Sarah’s doctors planned for her next step in care. Her family and staff who cared for her said she had shown improvements during the last month. Pediatrics employees said the hospital was seeking a placement for her in the Children’s Long-term Inpatient Program, Washington’s most intensive psychiatric treatment for children. But spaces are severely limited, and finding a bed can take months.
Now, Joseph said her family is requesting her sister’s medical records to better understand what happened to her in Sacred Heart’s care. They’re looking for a lawyer, too.
But this week, the family is taking time to grieve.
Family, school children and community members filled the Riplinger Funeral Home in Cheney Tuesday morning to remember Sarah. They sang a South African hymn, prayed and listened as Joseph, standing next to a white casket with pink trim, spoke about her sister before saying goodbye for the last time.
Reach Whitney Bryen at 208-918-2458 or whitney@investigatewest.org. Reach Kaylee Tornay at 503-877-4108 or kaylee@investigatewest.org.
This story was originally published by InvestigateWest, a nonprofit newsroom dedicated to change-making investigative journalism. Sign up for their Watchdog Weekly newsletter to receive stories like this one in your inbox.
InvestigateWest is part of the Mental Health Parity Collaborative, a group of newsrooms that are covering stories on mental health care access and inequities in the U.S. The partners on this project include The Carter Center and newsrooms in select states across the country.