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Creations of medical officers of mental health (MOMHs) then followed for Sri Lanka with the aspiration of having a MOMH in each of Sri Lankas 276 subdistricts – at a ratio of one MOMH per 70,000 population.
However such a ratio led to its own constraints with MOMH often suffering from excessive workloads: there were too many patients to see in the clinic or not enough valuable time spent with each patient in the clinic, shortage of essential medicines in clinics and inpatient units and a lack of community based psychiatric treatment settings.
Systematic training programmes have been introduced to help support mental health officers and for them to then pass on such trainings they receive downwards to the medical staff in their district.