This article draws attention to the issue of parental severe mental illness and the ethical and clinical implications for counselors who work with this population. Parents with mental illness face a multitude of life challenges including, but not limited to, parenting difficulties, medication and hospitalization, custody and placement of their children, financial constraints, and substance abuse. Counselors who serve this population need to be aware of some serious ethical and clinical issues they may face when working with this population. An illustrative case is used to highlight the nature of these issues and problems. Clinical and ethical recommendations are made for counselors.