Police and family members are becoming increasingly anxious about a missing psychiatric patient who has gone days without the medication needed to subdue his violent psychotic tendencies.

Just a few hours before Ashley Patrick Koftinoff walked out of the Hillside Psychiatric Centre and went missing Monday, Gwen Chernenkoff-Pegg spoke to her 37-year-old son, who police describe as “violent, mentally unstable and suicidal.”

“He sounded fine. I was just very surprised when I heard at 9 p.m. that night that he’d walked away at about 7:30 p.m. on an authorized leave and he just didn’t come back,” she said.

She’s spoken to media urging her son to return to the facility “to get the care that you need.”

Koftinoff, who was diagnosed paranoid schizophrenic at the age of 19, went on a violent rampage in the Hillside Psychiatric Centre on Friday threatening to chop the heads off police and sending staff scrambling for safety behind a security barricade.

On Monday, medical personnel at the downtown Kamloops facility granted him a one-hour pass and he’s been missing ever since.

Dr. Paul Dagg said medication can successfully treat psychosis in a patient within a few days and it’s not unusual that they would then be granted leave.

But as the days go by without the critical treatment, authorities and family members are getting more and more worried.

“Today I’m having a difficult time,” said Chernenkoff-Pegg on Wednesday. “It seems like the longer that he’s missing the more intense it is because the longer he is without any medication.”

Police dispatched bulletins across the southeastern region to find Koftinoff, said RCMP Staff Sgt. Grant Learned.

“Without having access to his medication since Monday, there’s a concern that his overall mental health may be taxed.”

Police believe he’s left town and may be headed back to Castlegar where his friends, family and associates live.

They issued internal bulletins and a public safety alert on Tuesday.

“We’ve been in contact with the detachment in Castlegar. They’ve dealt with him in the past,” said Learned.

Chernenkoff-Pegg said she also spoke with Castlegar RCMP who told her they were surprised when they read the bulletin.

“Because they have not had to deal with him on a violent nature here in Castlegar,” she said.

Koftinoff has previous arrests for assault and uttering death threats. But Chernenkoff-Pegg said at heart, he’s a mild man.

“He’s a very gentle soul. He would never hurt anyone. He loves animals. He’s very fond of dogs that we’ve had and he still speaks about them all the time.”

But she still says the public should stay away from him and call 911 if they spot him.

“It’s because if he’s fearful, you just don’t know,” she said. “I don’t know what he’s thinking. I do know that he’s not thinking straight because of his behaviour.”

She suspects that a change in medication to accommodate improvements he recently showed may have been at the root of his relapses.

But the information was sketchy since she spoke only to nursing staff.

Koftinoff had only just allowed his mother to get his medical information, but key decision makers have not been available.

“I wasn’t able to make contact with his social worker. And I understand his psychiatrist is away on holidays and the person looking after him is not on site there.”

Chernenkoff-Pegg plans to travel to Kelowna and Kamloops over the weekend distributing her son’s photo if he’s still missing.

Meanwhile, Kamloops RCMP were taking no chances on Wednesday. They alerted sheriffs at the Castlegar provincial courthouse, where Koftinoff was scheduled to appear on Wednesday accused of inducing fear and injury or damage.

“That’s strictly on speculation and in the interest in both his safety and the safety of the staff in the courthouse,” said Learned.

Koftinoff didn’t show.

Koftinoff is described as a white male, six feet tall, 200 pounds with a stocky build, short brown hair and brown eyes. He was wearing black jeans and a blue shirt and is rarely seen without his camouflage toque.

The RCMP is asking anyone who sees Koftinoff to contact their local police and warn members of the public. Police urge residents not to approach or restrain him.