The jury at the highly anticipated public inquest into the death of Samwel Uko heard more about his behaviour leading up to his death on Tuesday in Regina.
The inquest is now on its second day.
Uko, a 20-year-old football player from Abbotsford, B.C., died at Wascana Lake on May 21, 2020, while in Regina visiting an aunt. His family said it was a suicide.
Leading up to his death, Uko had sought medical help twice for mental health issues, and was forcibly removed from the Regina General Hospital. Uko was removed due to a lack of clarity and communication issues in Uko's registration information. His body was found in Wascana Lake about an hour later.
On Tuesday morning, the jury heard from Amanda Johansen, a former education assistant at Abbotsford Senior Secondary School, where Uko attended before his graduation in 2018.
Johansen said she had a close relationship with young Uko, and that he was well-liked.
He was "laid back, easy going, always had a smile on his face," Johansen said.
But she said they did not maintain contact after he left school.
Then, on May 21, 2020, Johansen was made aware through an educational assistant group chat that Uko had been posting concerning messages on Facebook, including "I need help."
Various people, including Johansen, started messaging with and calling Uko. She said he was acting paranoid, and that she had never seen him act like that.
"I don't think any of us knew the extent of it, but we knew he needed help."
Johansen said those who were messaging Uko "couldn't talk him down."
"We messaged him so many times, there were so many people calling him."
When asked what she would have like to see done differently at the hospital when Uko tried to get help, Johansen said she wished "that somebody would have looked at his phone at the hospital."
"Then they would have seen many of our messages and calls, and could have messaged us."
Johansen said she does not believe that Uko was taken seriously at the hospital. Her voice broke as she described Uko's character.
"He was such a good boy."
Nancy Klop is also an education assistant at Abbotsford Senior Secondary School. She supported Uko with multiple classes when he attended the school, primarily English.
Klop said Uko was one of learning support services' favourite students.
"Everyone liked him."
On May 21, 2020, Klop was also part of the educational assistant group chat that was concerned about Uko's behaviour. He was "incoherent," she said.
"It was totally out of character of him. Something was wrong."
ER nurse testifies
Scott Harrison, an emergency room registered nurse with the Saskatchewan Health Authority, also testified on Tuesday morning.
Harrison said he conducted a primary assessment of Uko during his first visit to the Regina General Hospital on May 21, 2020, at about 9:45 a.m.
Uko seemed withdrawn and had trouble making eye contact, Harrison testified. However, he said Uko did not have trouble answering questions.
Uko told Harrison he was having depressing thoughts and suicidal ideation. He described being stressed about not finding work during the pandemic. Uko also said he was having trouble sleeping.
Uko was in a motor vehicle accident on June 3, 2019, and he shared that information with the nurse.
After the primary assessment, Harrison said Uko was then handed over to another nurse.
A change that has now been made to ensure every patient sees a nurse and physician before leaving an emergency room is a good way to help ensure that what happened to Uko does not happen to anyone else, Harrison told the jury.
When asked about diversity training in the hospital, Harrison said nurses like him do receive some, but he could not recall his last session.
Social worker, Wascana witness, ER doctor testify
Bobbi Jo Slinn, who works at Mental Health Clinic, testified Tuesday afternoon. She was the social worker who Uko was referred to after his first ER visit on May 21, 2020. She said they had a phone conversation within hours of him leaving the hospital.
Slinn said that when they connected, Uko sounded shocked and asked why she was calling him. They talked for over half an hour. She said it was difficult to get out of him where he was, where he was living and why he was in Regina. She described his demeanour as "flat" an "low."
Uko was not able to provide examples of support systems he may have had.
Slinn referred Uko to a psychiatrist, who wanted to offer Uko an appointment that same week. But they never met.
Slinn didn't find out Uko had died until May 28, 2020.
Regina resident Shaharn Haque was cycling on the evening of May 21, 2020, in Wascana park when he got tired and sat on a bench. Then he saw Uko talking to himself.
Haque testified that Uko took off his jacket and entered the lake. He said the man came out of the water twice before disappearing into the lake and not coming back up.
Haque said many people were present, and the police were called.
Dr. Amy Goodday testified next. She works in the Regina General emergency room, and assessed Uko during his first ER visit on the day of his death.
She said she was impressed that Uko brought himself into the ER to get help. She testified that since his motor vehicle accident in 2019, his mood had been up and down. He told her that he had trouble concentrating and wanted help sleeping. Uko wanted to try out for the University of Regina Rams football team, but he was having difficulty training.
Goodday said that during their discussion, Uko made good eye contact, was coherent and pleasant.
When asked what needs improvement at Regina General, Goodday said it needs more staffing, a mental health hospital and more rooms in the ER.
Writing "Daudau" was a mistake
Ronda Schmalenberg testified next. She was the registration clerk at Regina General who registered Uko the first time he sought help. She admitted that she was confused by his B.C. drivers licence. Thinking it was his surname, Schmalenberg registered him with the surname "Daudau."
She said Uko was acting "incoherent" at the time and told her he was hearing voices.
When he returned to the hospital that afternoon, he registered under the name "Uko."
On Monday, Saskatchewan Health Authority official John Ash told the jury that he does not think anyone directed Uko to be escorted out of the hospital. He thinks it was a miscommunication.
The SHA had previously revealed that, due to the pandemic, people weren't allowed to hang out in the hospital at that time, and that contributed to Uko's removal by security.
The jury at the inquest, which began Monday at the Ramada Plaza hotel in Regina and is set to continue for at least a week, will hear from 25 witnesses in total.
The purpose of the inquest is to investigate when and where Uko died, as well as the medical cause and manner of his death. From there, the coroner's jury can make recommendations to prevent similar deaths.
If you or someone you know is struggling, here's where to get help:
This guide from the Centre for Addiction and Mental Health outlines how to talk about suicide with someone you're worried about.