A 31-year-old escaped from mental health care before he was allegedly involved in a double-fatal road crash. (ABC News: Timothy Ailwood)

A man accused of killing two women in a road crash in Sydney’s south-west had escaped from a mental health hospital nearly one week before the incident.

Teacher and charity director Lee Casuscelli, 60, and her passenger Maureen Crosland, 84, died when their car was struck by an allegedly stolen vehicle in Camden on February 14.

NSW Police said officers began pursuing a red sedan after it was stolen from a petrol station in Hurstville.

The car was later sighted in Beverly Hills, and a pursuit started, but the operation was called off about 40 minutes before the crash occurred.

The crash occurred on February 14 in Camden, leaving two women dead. (ABC News)

The ABC understands the 31-year-old driver had been detained involuntarily under the NSW Mental Health Act at Cumberland Hospital, Australia’s largest mental health facility, which is operated by the Western Sydney Local Health District.

On February 8, the man allegedly threatened a nurse and took an access card before absconding from care.

A spokesperson for Western Sydney Local Health District said NSW Police were immediately notified, but the man was not located and there was no record of him being returned to a NSW Health facility.

An allegedly stolen car that police had been pursuing is at the centre of investigations. (ABC News)

“The safety of our patients and staff is a priority for Western Sydney Local Health District,” the spokesperson said.

NSW Police were unable to comment as the incident remains under investigation.

Second patient to abscond

Separately, health authorities confirmed Setefano Mooniai Leaaetoa, 25, who is accused of stabbing three people in Merrylands earlier this week, killing one, had also absconded from Cumberland Hospital days before the alleged attack.

Western Sydney Local Health District said Mr Mooniai Leaaetoa left care on February 7 while being transferred from Cumberland Hospital to the emergency department at Westmead Hospital for further treatment.

Cumberland Hospital is a mental health facility located in Westmead, in Sydney’s west. (ABC News: Timothy Ailwood)

Police were notified and attempts were made to contact his family, but he was not located.

It comes as the state’s mental health system faces renewed scrutiny.

Last year, the ABC reported that Cumberland Hospital was facing significant staffing shortages, with staff warning that the system was under considerable strain.

At the time, two mental health wards and a mental health assessment centre at Cumberland and Westmead hospitals were quietly closed.

Only one trainee psychiatrist was available to cover the Cumberland facility overnight.