The assumption that seriously mentally ill people do not have children is common but inaccurate. In fact, although mentally ill men have fewer than normal numbers of children and have relationships with their children less frequently, mentally ill women have fertility rates that equal or exceed the general population. Children of persons with serious mental illness are at risk for poor adult outcomes due to a variety of causes which include genetics and environment. The questions that become important to answer then are: Why are some offspring resilient in the face of genetic risk factors for serious mental illness? and Why do some offspring of parents with serious mental illness do well in spite of adverse environments? The examination of outcomes in adult offspring of seriously mentally ill persons and factors associated with positive outcomes helps provide a foundation for the development of interventions to promote positive outcomes in this population. This study also provides important clinical information for professionals who routinely interact with these children and their families.