Kerrod Thomas Staines, 34, attacked Emma Larnach as she slept in her Brisbane unit on December 30, 2022, plunging a knife into her body, back, arms, buttocks and face.
She woke to find him on top of her, laughing and stabbing, before somehow breaking free and fleeing the bedroom, Brisbane Supreme Court was told on Wednesday.
Her friend David McNamara tried to help and was knifed in the back as Staines tried to force his way to Ms Larnach again.
Staines had been turned away from hospital days earlier after begging to be admitted due to having homicidal thoughts.
Ms Larnach, aged in her 40s when the attack occurred, lost so much blood she needed emergency surgery and transfusions to survive, the court was told.
Staines, who pleaded guilty to attempted murder and unlawful wounding, has been jailed for eight-and-a-half years.
After months in hospital, Ms Larnach is left with heavy scarring, chronic pain and reduced use of her right arm.
In a victim impact statement, Ms Larnach said she was stabbed more than 20 times and no longer recognised her life.
"I don't sleep anymore at night," she said.
"I have Kerrod constantly waking me up, repeatedly stabbing me in my mind."
She said all her teeth had to be removed after the knife punctured her gums and her face as she screamed for help.
"One of the scars runs the length of my face," Ms Larnach said.
"I don't have mirrors in my home anymore."
She said she now hides away in tracksuits and bathrobes - too anxious and ashamed of her scars to go out with friends or feel safe around men.
Staines, a long‑time schizophrenic, walked into hospital days before the attack saying he had homicidal thoughts about Ms Larnach.
Justice Peter Callaghan said Staines begged to be admitted but was turned away and sent to a backpackers hostel.
"The perfect storm gathered in December of 2022," the judge said.
"You were expressing paranoia and homicidal ideas … but you were not considered to be a high enough risk to warrant a placement."
Justice Callaghan called the decision "more than regrettable" and said if Ms Larnach had died, it would have triggered an inquest.
Because she survived, "there is no formal mechanism" to examine the system failures, he said, urging prosecutors to alert the attorney‑general and health authorities.
Crown prosecutor Joshua Francis said Staines had multiple opportunities to stop his attack but only quit when Mr McNamara intervened.
Defence barrister Victoria Trafford‑Walker said Staines' paranoid schizophrenia, years of homelessness and heavy drug use had wrecked his life.
Staines apologised immediately after the stabbing and later asked police about Ms Larnach's condition.
The court was told he was now on medication, doing courses in prison and engaging with mental health services.
Justice Callaghan said Staines had shown himself capable of "wicked actions" but could still function in the community if tightly supervised and treated.
Staines will be eligible for parole in December 2028.
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