A relevant literature review indicates that parent psychopathology can be an important factor in child maltreatment; however, there is little data on the types and extent of diagnoseable pathology in the general population of those who are known to have abused or seriously neglected their children (Taylor et al., 1991). Parents with a dual diagnosis of mental illness and substance abuse generally exhibit the exacerbation of symptoms, more frequent relapses, greater treatment noncompliance, and more violence. The impact of severe mental illness (SMI) on parenting behaviors will vary according to both the diagnosis and the severity of the symptoms. The impact will also differ with the age of the children. Parenting by persons with SMI tends to be less interactive, less responsive, less involved, and characterized by negative affect. From the child's standpoint, Dunn (1993) describes life with a psychotic parent as confusing and painful. Specifically, the pervasive neglect and the fear of physical harm take a toll. Services for mothers with SMI and their children are not always readily available. Especially lacking are training in parenting skills tailored to parents with SMI, as well as assessment of the child's needs for support and therapy. Mental health providers should assess parenting skills as part of the psychosocial rehabilitation process rather than wait until the children are at risk for placement. A case vignette with follow-up questions is presented. 21 resources