Mental illness impacts on more than the individualfamily members, including children, are inevitably impacted by their relative's illness. Moreover, the issues for families living with mental illness in rural and remote communities are considerable and often result in an overreliance on families for practical and emotional support. The subsequent burden of care alongside a lack of dedicated and timely services requires a specialized practitioner and systems response. The stigma associated with increased visibility of mental illness in rural and remote areas is another issue that impacts help-seeking and mental health outcomes. While the mental health issues for those living in rural and remote communities are a feature of much research, this chapter provides a new perspective by discussing the specific needs of families living with mental illness in these communities. Particularly at-risk groups including Aboriginal and Torres Strait families, culturally and linguistically different families, and others will also be presented. Implications for practice, services, and professional and resource development conclude the chapter. Structural, organizational, and practice change is required to identify family members and to effectively recognize and address the needs of those with a mental illness and their families.