The "New York Model" is a conceptual framework for discussing symptom severity, locus of care, and level of service integration needed among the mental health, substance abuse, and primary health care systems.

The underlying assumption of the "New York Model" is the fact that people with co-occurring disorders vary in the severity of their mental health and substance abuse disorders.  

The model is based on the fact that these differences in severity determine where individuals receive their care, including the primary health care, mental health care, 
and alcohol and other drug systems.

Key Points:

• The framework is based on symptom severity, not on specific diagnoses.  As such, it encompasses the full range of people who have co-occurring mental health and substance abuse disorders.
• The framework permits discussion of co-occurring disorders along several dimensions, including symptom severity, locus of care, and service coordination.  It permits a number of key decisions to flow from it, including the level of service coordination and best use of available resources.
• The framework delineates different levels of service coordination- defined as consultation, collaboration, and integration- rather than specifying discrete service interventions.  It is a flexible approach that can be adopted or adapted for use in any service setting.
• The framework highlights two levels of service coordination - consultation and collaboration - that do not require fully integrated services.  It points to the fact that many individuals can be appropriately served with interventions that fall short of complete integration.

Group descriptions

Group I
Less severe mental disorder/less severe substance disorder

Group I includes persons whose symptoms are not severe enough to warrant specific mental health or substance abuse treatment, and those persons who have not been adequately  screened and assessed for this need.  This group is a particular concern because it includes many children and adolescents at risk for developing more serious symptoms of co-occurring disorders.  If members of this group are receiving care, they are receiving it in the following settings:  primary health care, emergency rooms, school- based clinics, community programs, or no care.

Group II
More severe mental disorder/less severe substance disorder

Group III
Less severe mental disorder/ more severe substance disorder

Groups II and III may be receiving some level of care in the mental health and substance abuse system.

Group IV
More severe mental disorder/more severe substance disorder

People in Group IV are those with the most severe mental illness, substance abuse, and life functioning problems.  They are probably not effectively engaged in a continuum of care, have repeated and frequent relapses, and are more likely to be found in inappropriate settings (e.g. jails, prisons, forensic centers, homeless or in shelters or unstable housing) as well as in and out of mental health and substance abuse services.