Parental mental illness is a risk factor for a range of negative experiences for children and young people. Evidence shows that it affects, and is affected by, family contexts, and whole-family involvement in treatment can be beneficial. However, UK mental health services have been criticised for their response to parental mental illness, and little is known about assessment and practice in areas where support is available. This article presents results from an audit of mental health services in one English region. Results indicate that there is a high prevalence of parental mental illness, but that assessment of cases and provision of appropriate family support are inconsistent.