| Summary: | Background: Little is known about the development and use of skills within functionally differentiated specialist mental health teams.Method: A prospective cohort study of skills acquisition and a cross-sectional investigation of family work in a specialist early psychosis service (COAST) were carried out, using generic community mental health teams (CMHTs) for comparison data.Results: Self-reported skills improved over time in the COAST team, but not in the comparison CMHT. All staff acknowledged the importance of family work in psychosis, but COAST staff had access to supervision and engaged more in family work. The pattern of family work undertaken differed from that reported in research studies.Conclusions: Tracking the acquisition of skills by mental health staff is feasible. However, clinical skills are used differently in routine services and in research settings. Most families in early episodes of psychosis need relatively low intensity support, such as information and a clear contact point.
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