Courtesy of Geetha Jayaram, M.D., M.B.A.
Psychiatrist Geetha Jayaram, M.D., M.B.A., said her humanitarian work in
India brings a great deal of meaning to her life.
When Geetha Jayaram, M.D., M.B.A., sat down to interview for the Johns
Hopkins psychiatry residency program after graduating from medical school in
India in the 1970s, she fielded an important question: if gifted physicians
continually come to the United States to pursue training and a career, how
does this affect patients living their native countries?
"This question has always stayed with me through the years of raising
my family and making a life for myself" in the United States, Jayaram
told Psychiatric News.
Though she tried unsuccessfully to obtain a job as a psychiatrist in India
after completing her training at Johns Hopkins in 1981, she has made up for
lost time by returning to her native country 20 years later to ensure that
people living with mental illness in remote villages receive the care they
"I can now give much more than what I could have if I had lived
there," she said, referring to the considerable experience she has
acquired in the United States as a community psychiatrist and academician.
She is an associate professor of psychiatry at Johns Hopkins and physician
advisor in the Department of Psychiatry and also maintains a private
It is perhaps her work as a community psychiatrist that best prepared her
for the work she would undertake in India.
As director of mental health in Prince George's County, Md., in the 1980s,
Jayaram ensured that public-sector patients with serious mental illness would
receive continuous care by organizing a network of physicians who would travel
between community mental health centers in the county and continue seeing
patients during periodic hospitalizations. "This seemed like a small
thing to do, but it had never been done before," she noted.
In addition, she organized an outreach effort in which county vans that had
previously been sitting idle circulated around the community to pick up
patients and bring them to a clinic where they could receive depot prolixin
"After receiving their treatment, the patients would frequent the
local businesses. They began to look forward to these outings. It was like a
social day for them," Jayaram said.
In subsequent years, Jayaram would go on to direct a 1,000-patient
community psychiatry clinic and the AIDS Psychiatric Evaluation Unit, both of
which are affiliated with the Department of Psychiatry at Johns Hopkins. It
was under Jayaram's leadership that the clinic won APA's Psychiatric Services
Gold Award in 1989.
Throughout her career, Jayaram has been interested in ensuring that
psychiatric services are run efficiently. In the 1990s, she fine-tuned her
administrative skills by earning an M.B.A. from Johns Hopkins after taking a
position as physician advisor in the hospital's psychiatry program.
As physician advisor, she oversees the quality of psychiatric services
offered at Johns Hopkins. She is responsible for issues related to
credentialing, risk management, and adverse medical events and supervises a
staff of more than 200 psychiatrists.
"The physician advisor's work has become increasingly important with
the emphasis on quality of care and safety in the medical arena," she
She also teaches psychiatry residents about these issues during rounds on
morbidity and mortality. She chaired APA's Scientific Program Committee in
2003 and 2004 and currently serves on the PsychiatricNews
and Focus editorial boards.
As her career unfolded, the question posed to Jayaram as an international
medical graduate on the brink of a career in the United States would one day
take center stage in her professional life. That is, how could she help
underserved populations living in her native country?
Humanitarian work runs in Jayaram's family. Her father was a philanthropist
and "trained us to help the poor and under-privileged" by
providing them with education and employment opportunities, she said. He was
also a lifelong member of the Rotary Club, an international service
organization of professionals who provide humanitarian services around the
Jayaram has two brothers living in India who perform humanitarian services
as Rotarians. A third brother, who has since died of leukemia, raised hundreds
of dollars as a Rotarian to establish a blood bank in Bangalore, India.
Jayaram joined the Rotary's Rotaract youth service club and met her
husband, Jay, as a young Rotaractor in India when she was 19 and he was
Rotaractors are members of the Rotary's youth service club who perform
community and international service projects.
So when Jayaram decided to organize a mental health outreach project in
India, it seemed only natural that she would raise the funds through the
Through the Rotary Club of Columbia, Md., Jayaram raised $25,000 by
organizing workshops for women throughout India and received a matching grant
through the Rotary Club in 2002.
The money enabled her to hire a team of health care workers to conduct a
door-to-door survey of approximately 17,000 households in 30 villages outside
of Bangalore and to screen people for mental health problems.
Those who screened positive for psychiatric symptoms were brought to a
mental health clinic established by clinicians from a local medical school to
be evaluated. A local psychiatrist visited the villages on a weekly basis to
treat those with psychiatric symptoms.
Jayaram and her team studied 300 of the villagers who received treatment
Using the Structured Clinical Interview for DSM-IV-TR, they
confirmed diagnoses of depression in more than 200 patients, the vast majority
of them women.
"Women are twice as likely as men to suffer from depression and
anxiety, and their needs are often ignored" in Indian culture, she
Using the Hamilton Depression Rating Scale, they found that 129 of this
group had significant depression six months after their initial treatment.
Depression had remitted in 72 of the patients.
They also found that comorbid anxiety was a significant factor in those
with persistent depression.
Jayaram plans to raise more funds through the Rotary to ensure that those
with depression continue with treatment. "Many of the villagers live
hand to mouth" she said, and cannot necessarily afford to take time off
from working in the fields to receive treatment at the clinic."
The additional funds would permit case-workers to go to patients' homes
with medicines, she added.
Jayaram has also provided volunteer services for the Maryland Psychiatric
Society and the Disabled Persons Review Boards for two decades. "My
humanitarian work is gratifying and brings much meaning to my life, and
hopefully to the lives of others as well," she said. ▪