A second patient has disappeared from the Forensic Psychiatric Hospital in Coquitlam in less than a week, prompting questions about whether the hospital is doing enough to keep tabs on its patients.

One of the two patients on the lam is David Fomradas, who was involved in a bizarre carjacking involving a Vancouver actress in 2009. The last time he walked away in 2012, the hospital cracked down on visits and launched a major internal review.

Fomradas "failed to return" to his housing program Wednesday. Police say he may be violent if he's off his medication.

The other patient, 41-year-old Violet Edna Miharija, escaped late Friday night. She has a decade-long track record of impaired driving and theft charges, and was remanded to the Forensic Psychiatric Hospital to determine if she is fit to stand trial.

Police say Miharija is unlikely to be violent, though Coquitlam RCMP Cpl. Jamie Chung asked the public not to approach either of them and call 9-1-1 so they can be returned to the hospital.

"These people are in need of help," Chung said. "They are there for a reason, they are suffering from mental illness."

Shortly after Miharija escaped, the nearby Kwikwetlem First Nation said an alarm went off on its property, which is very close to the hospital.

"Someone tried to jiggle a window and the alarm scared them off, whoever that might have been," he said.

"I'm fearful for the nation. We've got kids here. We've got elders here. God forbid something bad happens," said Lessoway.

Lessoway said things have improved since the 2012 incident, and the hospital informed the First Nation about the incident. But he still wants a meeting with the hospital administration to follow up on ways to prevent escapes.

Fomradas was living in the Coast Cottages, and using regular day passes to legally return to the community - a vital part of rehabilitating a patient, said the hospital's executive director, Angela Draude.

He had been at the cottages since Dec. 31, and doctors believed had made great strides since his 2012 escape.

"I can say he appeared to be doing rather well," she said, noting the hospital considers his case an unauthorized absence after Fomradas failed to return from a day pass outing.

However, Miharija was on remand from Alouette Correctional Centre and was awaiting an assessment of whether she was fit to stand trial on non-violent offenses, Draude said. 

The hospital has started an internal review of the cases to see what led to both going missing.

There are 188 people staying in the 190-bed facility, with about 31 extra spaces at the Coast Cottages, officials said.

Escapes at the facility have become much less common. Reports say in 2010 there were 20 escapes, in 2011, 17, and in 2012, just five. Since then, the hospital says just five people have gone missing.