Parents who have serious and persistent mental illness are often overlooked in social work and mental health journals. Furthermore, mentally ill parents typically are viewed from a pathology perspective that fails to address their desire to be competent parents. This article reviews the literature on mentally ill parents and addresses conceptual issues in assessment and services. The author critiques methods of assessment and recommends more appropriate and comprehensive assessment protocols. Model programs are discussed with a focus on the development of competent parenting skills combined with social supports for parents who have a serious and persistent mental illness.