When Dorothy Roane's two teen-age sons found her at 14th and Girard streets NW, she was wandering around confused, combative and with fresh needle tracks on her arms.

Just how the 34-year-old woman got there is not clear.

What is known is that she has been a mental patient at St. Elizabeths Hospital for several years and had been able to leave the grounds last month without being stopped by hospital security personnel and then wound up in one of the city's notorious drug areas.

When her sons, who are 18 and 19, found her with the help of an off-duty District police officer, Roane was still wearing her thin hospital slippers and had been missing about five days. When she pointed out the man she said sold her drugs, one of her sons punched him in rage, starting a scuffle that attracted police.

The hospital has a security patrol and a brick wall around its 330 acres, but it would not be difficult for patients to leave, said Ray Becich, a hospital spokesman. "If someone really wants to get off the grounds, or onto the grounds, they certainly can," he said. "This isn't a prison. It's a hospital."

Only a week before her disappearance, Roane had been released from the John Howard Pavilion, the hospital's maximum security facility that houses persons sent to St. Elizabeths by the courts when they have committed crimes but are judged mentally ill.

Roane was taken there after being found guilty in 1976 of assault with a gun, according to court records. She had a history of heroin addiction and was considered depressive and suicidal, the records indicated.

John Howard Pavilion is used for patients who are the greatest risk to themselves or the community, Becich said. Patients may be moved out when it is judged they have pro- gressed to the extent that they do not need such a restrictive environment, he said.

Roane's mother, Dolores Holland, said she is disturbed and angry with the hospital's handling of the situation.

"St. Elizabeths didn't do nothing" to find Roane, Holland said. She and a grandson said that the hospital staff did not inform the family for days that her daughter was missing and did little to help locate Roane.

Becich said hospital records indicate that Holland was informed the same day Roane was found to be missing. After hospital security guards and staff members search hospital wards and grounds for a patient, St. Elizabeths relies mainly on city police and family to find the missing person, he said.

Norman Rosenberg, director of the Mental Health Law Project, which has monitored St. Elizabeths for years, said that although the hospital does not seem to have an unusual number of patient elopements, "it should not happen that people can wander off the grounds."

An incident such as Roane's "does require a more careful look at security procedures to see if they meet the needs of the population" and to make sure the community is protected, Rosenberg said.

Becich said a policy review is required only if the occurrence is unusual in some way or if the staff handled the situation improperly. "Patients do elope from hospitals. The staff handled this [the Roane case] quite appropriately."

The hospital has 14 full-time guards at the John Howard Pavilion and a total of 35 guards on staff to provide round-the-clock security for the rest of the complex, he said.

Becich said hospital staff members report missing patients to security police about three times a week, but that usually patients turn up in the wards or on the hospital grounds. Most patients are in the hospital voluntarily, and part of treatment is mutual trust between patients and staff, he added.

Roane was not there voluntarily. She was charged in 1974 with assaulting a woman while using a gun and in 1976 was sentenced to three to nine years, according to records in D.C. Superior Court.

Last month she was released from John Howard and put in another area of the hospital with ground privileges. A week later Roane went outside and did not return.

Holland said she had asked the hospital to tell her when her daughter was to be moved to the less restrictive area and allowed onto the grounds so Holland could go there and help Roane adjust to the new environment. But, Holland said, the hospital did not tell her when Roane was moved on March 14.

Roane was discovered missing on a Thursday, but Holland said she did not know about the disappearance until the next Sunday night when she called the hospital to talk with her daughter. Someone had called a day or two earlier asking if Roane was with her, but did not say why the caller was asking, according to Holland.

Becich said the hospital's records show that Holland was informed her daughter was missing the same night it was discovered. The records also show a call from Holland several days later asking where Roane was, he said.

Roane's 18-year-old son Eric said the family found out about the disappearance that Sunday and that he and his brother Robert, 19, went looking for her.

"Nobody [at St. Elizabeths] helped us at all," said Eric Roane. Hospital staff members told the sons to talk with hospital security guards, who said they had filed a police report.

He also said police did little, and Holland said she heard from a police detective only after Roane had been missing about five days. After another friend called to say she had sighted Roane with a man on upper 14th Street, the sons went there.

After one unsuccessful search, Eric and Robert Roane finally found their mother on a Tuesday night and took her home to Holland's house. She was wearing a thin jacket and a dress over a pair of slacks and looked as if she had been out in the rain, Eric Roane said. "We could see the needle marks on her arms," said Holland.

She was returned to St. Elizabeths the next day.

Eric Roane said with or without help, he and his brother were prepared to keep searching as long as it took, even if they had to take off from school and work. "We stayed out there for hours," he said. "We were just looking for our mother."