Only three mental health patients walked away from the Hawai'i State Hospital in 2007, the lowest number in years and down markedly from dozens of escapes annually a decade ago.

On Monday, Casey Nies, 36, became the fifth patient to walk away from the facility so far in 2009. Nies, whom police said was considered dangerous, was recaptured yesterday afternoon without incident some 30 hours after he escaped.

The number of escapes — "elopements" in state hospital jargon — has dropped dramatically at the hospital since 49 were recorded in 1997. Last year, there were six.

But even one is too many, hospital officials said.

"We're always working to try to improve, because we know that even a single instance of elopement might be too many," said Mark Fridovich, hospital administrator.

The state hospital is next to Windward Community College, Kane'ohe District Park and the Castle Hills subdivision, where hundreds of students, young children and families live, attend school and play.

Security at the hospital has been improved in recent years, and more changes are on the way.

In 2007, the hospital installed new fencing. In previous years, other improvements also were made, including putting in new lighting and security devices.

Officials also have appropriated $2 million for the installation of new security cameras and a "perimeter fence monitoring system" on the campus. The projects are out to bid now, officials said.

BELOW CAPACITY

Fridovich wouldn't discuss the circumstances of the Nies incident. However, he said, there were 178 patients at the facility at the time, below its licensed capacity of 202. He also said that an "adequate" number of staff was present.

He also noted that an "elopement" doesn't necessarily mean the patient isn't on campus. Staff just doesn't know where the patient is, he said.

John Flanigan, who serves on the hospital's Citizens Advisory Committee, said he wondered how Nies could have gotten loose, because, he said, the facility has surveillance equipment that covers 99.9 percent of the campus.

Flanigan, who also is a Kane'ohe Neighborhood Board member, backs the work of the hospital and its staff.

"My impression is that they do a pretty good job with what they have, but they don't have the facility that they need," he said. "The big problem is they don't have control over who they get or who they let go. About 95 percent of the patients are court-appointed."

The biggest drop in escapes — more than 50 percent - came from 2001, when there were 28, to 2002, when there were 12. The drop came after U.S. Magistrate Judge Kevin Chang was appointed special master over a consent decree that required the hospital to improve patient care. The federal oversight ended in 2006.

Since 2002, the number of escapes has averaged seven per year.

State Sen. Clayton Hee, D-23rd (Kane'ohe, Kahuku), said escapes are a reasonable expectation, and maybe state officials should be thinking about alternatives for the treatment of the most dangerous patients who pose a risk to the public if they escape.

"The public is concerned, based on the record of escapes from Kane'ohe, but the other side of the coin is: Are they receiving the services, and it may be better for them to receive them in a secured facility out of the state," Hee said.

SWORD ATTACK

Nies was committed to the state hospital after a circuit judge found him mentally unfit for trial on charges of attacking a Maui police officer in 2003 while carrying a samurai sword. An expert report back then described Nies as "actively psychotic."

Improvements at the state hospital have come amid a decrease in the population at the psychiatric facility. State officials said there were 168 people at the facility in March, down from 192 a year earlier.

Officials have said the decrease is in part because of more aggressive efforts to place people who are ready back into the community.

In seeking the public's help in finding Nies, police said he was dangerous. Three people called in his location at a Kahalu'u bus stop at 'Ahuimanu Road and Kahekili Highway yesterday afternoon, and he was apprehended at about 2 p.m., police said.

Sharon Colbert, a Kahalu'u grandmother, said she was going to pick up her grandson from school when she first spotted Nies walking toward 'Ahuimanu Road on the mauka side of Kahekili Highway. Recognizing him from a description in an Advertiser story, she said, she called police and watched him as he headed for the bus stop and sat on a bench.

"I was just driving along, and it just clicked in my head: bald, bushy beard — this is the guy," Colbert said.

She said she waited until police arrived because she feared Nies would board a bus and be lost.

"I had to go get my grandson," she said. "I couldn't follow the bus to see where he got off. I just parked and waited and prayed the whole time the police would come."