"Hi Helen, I'm really sorry," said a former real estate agent before allegedly plunging a knife into the chest of the woman in her Sydney eastern suburbs home.
Matthew Brian Ramsay was granted conditional bail in Waverley Local Court on Friday to reside for at least six months in a rehabilitation centre in Port Stephens.
He has been charged with causing wounding or grievous bodily harm with intent to murder.
At some point before midday on August 8, the 46-year-old had ingested some 120mg of Valium. The therapeutic dose is 40mg, the court was told.
He then attended Helen Coulston's Dover Heights house while she was home alone, according to the police facts of the case.
Ms Coulston had not seen Ramsay for a few months before he knocked on her door and was let inside.
Immediately he allegedly pulled out a knife 20cm long.
"Hi Helen, I'm really sorry," magistrate Ross Hudson said Ramsay told her, before causing a 4cm puncture wound near her heart.
He then swung the knife again but missed before a violent struggle ensued.
Ms Coulston managed to throw the knife onto the front lawn and a number of witnesses came to her aid.
Body-worn camera footage captured Ramsay telling police after his arrest: "I didn't mean to hurt her I just meant to scare her".
At the time he was unemployed with a number of significant payments outstanding, the magistrate said.
Prosecutor Chris Davis opposed bail saying his release could endanger the community, the alleged victim, and that multiple failed attempts at rehab showed further treatment was of no avail.
"(We have) little confidence it would do any real good in the short term," Mr Davis said.
Defence lawyer Ben Clark said it was not uncommon for the court to see cases such as his client's, with long-standing drug and alcohol misuse to have unsuccessfully tried to undergo rehabilitation.
He proposed the secure facility Ramsay would be placed into was even more restrictive than jail given he could not make any phone calls unaccompanied by a counsellor.
He said Ramsay had self-medicated with Valium to withdraw from alcohol, a substance he has had a history of abusing.
"This is effectively swapping one custodial environment for another," Mr Clark said.
Mr Hudson said there was some "absurdity" to Ramsay's behaviour with "no rhyme or reason to what he did that day".
There was no animosity or revenge between the pair, he noted
"Mental health may have played a significant role in what happened that day."
He said the unpredictability of the behaviour remained a concern, but the inexplicability of the incident was connected to alcoholism and underlying depression.
The magistrate granted bail saying he believed the tight restrictions could mitigate any risk to the community or alleged victim.
He ordered Ramsay not to enter the eastern suburbs unless attending court, and to not contact Helen Coulston or her husband Walt.
