The victim was pushed into the path of a train
Benjamin Rathbone carried out the attack on Loughborough station in February 1999 just hours after being released on home leave from a psychiatric unit.
The man he tried to kill, Will Hickin, has criticised the amount of time it has taken for the inquiry to be completed.
He also said he was still very upset about the attack.
The report said Leicestershire and Rutland NHS Trust had undertaken less-than-satisfactory risk assessment of the patient before releasing him on home leave.
Mr Hickin, who was at the train station to greet his daughter, was pushed onto the track by Mr Rathbone, who then leaped after him.
Both survived the incident, which was captured on CCTV, although Mr Hickin sustained a dislocated shoulder and cuts and bruises. He was also emotionally distraught.
Mr Rathbone pleaded guilty to attempted murder on 28 June 1999 at Leicester Crown Court and was given a restricted hospital order without time limit because of his mental illness.
He had suffered from mental health problems and delusions since 1996, and was diagnosed as a paranoid schizophrenic.
Kitchen knife
The report said there was "a lack of on-going risk assessment by the authorities" when Mr Rathbone was given leave from hospital.
"Nothing was done to monitor his progress on leave and there appeared to be little opportunity or encouragement for the relatives to give feedback independently to the team caring for Benjamin," the report said.
The report said Mr Rathbone, who had history of violent behaviour, was in a bad mood on the day of the incident and decided to push someone in front of a train.
His home was searched after the incident and police found a large kitchen knife under the pillow in his bedroom.
The report said he was minimizing his psychotic experiences and good at concealing his thoughts and behaviour.
The trust should "ensure that sufficient in-patient beds are available for fuller assessment and treatment to avoid possible premature discharges," the report said.
The trust has welcomed the report's conclusions and has already taken some action, including the strengthening of risk assessment procedures and training plus the involvement of family in patient care.
It has also issued a full apology to both Mr Hickin and to members of Mr Rathbone's family.