In a statement, the Hawaii State Health Department said, "The Hawaii State Hospital staff takes all escapes seriously and has safeguards in place to minimize the chances of these from occurring. A thorough investigation is now underway to gather more details and to identify areas for improvement."
Over the last few years, the department has worked to improve security at the facility. Improvements include additional staffing in areas requiring more supervision, installation of security screens, double-locking exterior locks and improved hourly census-taking protocol.
Additional fencing has also been installed and officials ensure adequate staff is on hand at all times.
"We train staff regularly on new procedures and constantly remind them to be vigilant in their work to monitor patients," the health officials said.
But one employee who spoke anonymously to Hawaii News Now said the staff feels the exact opposite and that morale is poor.
"I want the public to know something rotten is going on at the hospital," the worker said.
According to the staffer, some workers feel overworked, frustrated and upset over mandated overtime. "That's creating a lot of people being quite pissed off and quite frankly, they've kind of given up. They don't care," the worker said.
Hospital communication among employees and the public is also an issue, the staffer said.
Nixle is a public alert system used by county officials to get the word out about emergencies. The hospital started using it to alert the public about escapees, but there was a delay — and disagreement internally on how long staff was unaware about Saito's escaped Sunday.
"You get management saying it was only two hours, but people that I know say it was completely different. It was more like 11, 11 and a half hours," the staffer said.
"He left at about 7:15 to go eat breakfast and they never noticed until 7pm when he was supposed to be there in person but he wasn't," said the staffer.
Crimestoppers says Saito walked away from the hospital at 9 a.m. Sunday, but it took more than nearly 12 hours for officials to send the alert through Nixle and to local media. The public was made aware of the escape around 8:39 p.m. Sunday.
Saito is the second patient to escape the facility this year.
The staffer said Saito was considered a non-violent patient for decades. He earned "unescorted grounds" privileges -- where he could roam the hospital property but had to check in hourly. Under this privilege, patients are supposed to call in once an hour. The staffer says alarm bells should have gone off within an hour.
While the staffer doesn't know how Saito got out, he thinks Saito had outside help and was planning an escape for a while because of his manipulative nature.
"They'll never find him," said the staffer.
"He's a smart guy. He's not impulsive. It's not an impulsive act. He had some planning. He had someone on the outside," said the staffer.
Hospital staff called the patient, Randy, and say he was a charming, likeable guy -- despite brutally shooting and stabbing a random woman at Ala Moana in 1979. He was found not responsible. His attorneys and doctors saying he was a necrophiliac and sexual sadist.
"He was a person overcome with sexual urges and the only way he can relieve them is inflicting great harm onto a female and then having sex with them," said the staffer.
The staffer says Saito is considered a psychopath unable to feel empathy for others, but was not getting the treatment he needed because he was refusing psycho-therapy. The staffer said he is not considered mentally ill so he was not taking medication.
When asked if Saito is capable of hurting someone else, the staffer said it's hard to say.
"The way he presents himself, it's like oh no way, but then again he's got a darker side," said the staffer.
The union, HGEA, confirmed there's a "prohibited practice complaint" currently filed with the Hawaii Labor Relations Board.
In September, Rhegan Kinoshita also walked away from the Kaneohe facility. Kinoshita was known to have a violent past, and the escape sent Windward Community College in to lockdown.