Moving patients who are mentally retarded and mentally ill out of state institutions and into the community has had minimal effects on mental health facilities, but state social service officials say that will change as patients continue to move out.

According to Gary Nakao of the State Division of Services to the Handicapped, something must be done now to provide dually diagnosed patients with sufficient care in adequate facilities.The State Board of Mental Health agreed to work out a policy with the Division of Services to the Handicapped at a board meeting at the Utah State Hospital Friday. Both entities will work out questions of how to serve dually diagnosed individuals, how to work with them and how to determine who will pay for the services.

"Outmovement from institutions has loaded your system acutely in the past three years," Nakao said. "But the more people that move out, the more complex problems they have," and the more help they will need.

He said 64 people from the State Training School were moved into the community in 1986, 130 people were moved in 1987 and 64 people have already moved out this year. He added that 130 intermediate-care facility patients with more complex problems will also be moved out this year.

Of 206 training school patients who moved out in a year's time, 14 have used state mental health facilities for medication management and eight for counseling. If services were more readily available, more people would use them, he said.

Len Schmidt, chairman of the state board, said mental health facilities have probably not been eager to care for dually diagnosed patients because they have a "fear of being swamped, but nobody is swamped yet."

The exodus follows a federally mandated requirement made to meet Medicaid standards and a state trend to de-institutionalize the handicapped and mentally ill, but "puts a lot of people in the community who still need mental health services," Nakao said. "We are not doing an adequate job. We are not mental health experts."

Nakao attended the Friday meeting to ask the board for help in confronting the problem of serving the mentally ill and mentally retarded patient.

"Our recommendation is that you commission our staff to study the issue and make a policy and recommendation on how we should approach the problem. Our division is willing to work with service providers of mental health. It is not our desire to set up a separate mental health system. We would rather do joint training."

Board members agreed to work with the handicapped services division. "We don't do a good job in our department in dealing with more than one board," said board member Keith Stroud. "I don't think we do well, but we probably ought to learn."