Varma Penumetcha, MD, FAPA Cascade Forensic Psychiatry

Varma Penumetcha, MD, FAPA

Board certified in forensic psychiatry, general psychiatry, and addiction medicine.

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Portrait of Dr. Varma Penumetcha

Medicine and the law ask different questions about the same person. A psychiatric diagnosis does not tell a court whether a defendant can stand trial, or whether an illness keeps someone from working. That is the work I do.

Competency Evaluations

Can a defendant understand the proceedings and assist in their own defense? I evaluate that question — competency to stand trial, competency to waive rights, and related capacity questions. Much of my clinical work has been inside the competency-restoration process.

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Criminal Responsibility

Criminal responsibility turns on the defendant's mental state at the time of the offense. I evaluate it, including Guilty Except for Insanity. I have worked directly with both insanity and competency-restoration populations, and I supervised a unit through the shift from one to the other.

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Civil and Disability Evaluations

Disability claims and decision-making capacity turn on psychiatric evidence. I evaluate both. My 2017 article in the Journal of the American Academy of Psychiatry and the Law examined how much weight a consultative examination should carry in a disability determination.

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Violence Risk Assessment

How likely is future harm, and to whom? I assess risk to self and others in inpatient and forensic contexts. The work draws on my APA-funded research, "Predicting Violence in Inpatient Mental Health Units of Community Hospitals," and on five years supervising complex psychiatric patients.

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Diagnostic Services

I provide clinical evaluations with diagnostic clarification for challenging cases. This work serves clinicians, institutions, and attorneys, and is retained directly by the requesting clinician or organization.

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