A missing convicted murderer could pose a potential risk to the public and himself, say police.
Richard Bracken, 48, failed to return to a psychiatric hospital in North Wales after an hour's unescorted leave on Monday lunchtime.
Bracken is said to be at risk of "becoming more unpredictable" without his normal medication.
He was last seen leaving Bryn y Neuadd Hospital in Llanfairfechan, Conwy, at 11.35am.
North Wales Police first issued a missing appeal on Monday evening but did not mention that Bracken was a convicted murderer or that he posed a risk to others.
Bracken, formerly known as Richard Dennick, was jailed for life for the brutal murder of a vicar in Llanberis in 1982.
The then 15-year-old attacked Canon Alan Jones, 64, in his rectory with a billiard cue, an ornament and a knife.
He is said to have later escaped from Lewes Prison in Sussex in 1989 and stayed on the run for six months.
Today, Detective Superintendent Mark Pierce, who is leading the search, said the hunt had now widened for Bracken who has family links in Essex.
Mr Pierce said: "It is becoming increasingly urgent for us to find Richard Bracken, a convicted murderer, who without his normal medication is at risk of becoming more unpredictable.
"Extensive searches of the Llanfairfechan area have so far proved negative and it is possible he may have left the area. Expert search advice has been taken and we continue to assess the situation.
"Without access to medication and healthcare support, Richard Bracken is believed to pose a potential risk to himself and others. Our intention is to alert people to the situation and not to cause undue alarm. I would urge anyone who sees him not to approach him and to immediately contact the police on 0800 096 1011."
Bracken is described as 6ft, of heavy build with short brown hair and with a stubbly beard. He was last seen wearing white trainers, a blue shirt, grey striped jumper, blue jeans and a green coat.
Angela Hopkins, executive director of nursing and midwifery at Betsi Cadwaladr University Health Board said: "We are becoming increasingly concerned for the personal safety of patient Richard Bracken.
"He failed to return to Ty Llewelyn, Bryn y Neuadd Hospital, Llanfairfechan, after an hour's unescorted leave in Llanfairfechan yesterday lunchtime.
"Any decision to allow community leave is only taken after a full risk assessment by medical staff and with the consent of Ministry of Justice officials under delegated authority.
"We believe that Richard Bracken is without his medication which he needs to take daily. Without it, we believe that he will become increasingly vulnerable. It may be that he is a risk to himself and potentially to others.
"We are working closely with North Wales Police who are continuing to search for him. He has family connections in Essex.
"We ask anyone who might have seen Richard Bracken to contact the police by calling 0800 0961011 and not approach him directly."