The NSW mental health minister confirmed on Thursday a man charged over a police pursuit that ended in the deaths of two women had fled from Australia's largest mental health facility on February 8.
It followed an earlier revelation another Cumberland Hospital patient absconded on February 7 before allegedly mounting a murderous stabbing spree on Tuesday.
The security breaches at the facility have prompted outrage from the NSW opposition.
The state's most vulnerable patients were being let down by a broken system, opposition mental health spokeswoman Sarah Mitchell said.
"Two escapes from the same mental health facility in just 24 hours is not a coincidence, it is a sign that something is seriously wrong within the system," she said.
Luke Peter Francis, 31, reportedly broke out of the western Sydney hospital four days after he was released from prison on parole.
He was an involuntary resident at the hospital when he fled, according to the mental health minister.
Francis was accused of threatening a nurse and taking an access card before escaping, Rose Jackson said.
She blamed police for not returning Francis to the hospital, even though his status had been changed from "absconded" to "discharged".
"I don't know why he wasn't brought back in if he was indeed mentally disturbed and he was also on parole," Ms Jackson said on ABC Radio.
"Police should have had the power to bring him back into a facility for assessment."
She launched an urgent review into the security protocols at Cumberland Hospital.
On Saturday, the 31-year-old allegedly stole a car and led police on a 40-minute pursuit across the city before crashing into a car in Camden South.
Teacher and charity director Lee Casuscelli, 60, and her passenger Maureen Crosland, 84, died when the stolen car illegally crossed into the intersection and struck their vehicle.
Francis is in custody facing a charge of aggravated dangerous driving occasioning death and will appear in court on February 26.
His escape happened a day after Setefano Mooniai Leaaetoa also absconded from Cumberland Hospital.
The 25-year-old was arrested on Tuesday after allegedly killing one person and injuring two others in a stabbing attack in Merrylands.
Leaaetoa is believed to have run from a health transfer vehicle while being moved to Westmead Hospital from the mental health facility, NSW Health confirmed on Wednesday.
He has been charged with murder and attempted murder.
Ms Jackson has previously conceded the mental health system is grossly underfunded.
The inquest into the Westfield Bondi Junction mass stabbing attack found multiple problems with NSW's mental health system, including the need to improve outreach and accommodation services.
Public hospital psychiatrists quit en masse in 2025 after years of growing vacancies, relatively poor pay, burn out and poor oversight of junior staff.
The state wages umpire granted an immediate 20 per cent pay rise in October to address the crisis.
NSW psychiatrists have called for careful, accurate and sensitive public discourse of fatal incidents.
"The vast majority of people living with mental health conditions are not violent," Royal Australian and New Zealand College of Psychiatrists' NSW branch president Ian Korbel said on Wednesday.
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