OBJECTIVE This study investigated the contributions that persons with serious mental illness make to their families according to both clients and family respondents. METHODS The sample consisted of 725 clients with serious mental illness and 725 family respondents living in rural counties or counties with small urban areas in Wisconsin. Clients were in contact with family respondents at least three times a year; 23.7 percent of them lived with the respondent. Clients returned a questionnaire, and family respondents completed a telephone interview; both rated the amount of help the client gave in eight areas such as household chores, shopping, and companionship. RESULTS Overall, the clients, especially those who lived with their families, provided substantial help. For the total sample, clients were most likely to contribute by providing companionship; family respondents reported that 59 percent of clients gave such help. For clients who lived with respondents, between 50 and 80 percent helped by doing household chores, shopping, listening to problems, providing companionship, and providing news about family and friends, according to family respondents. CONCLUSIONS Many persons with severe mental illness play positive roles in their families. Recognition of clients' contributions by providers, researchers, and clients and families themselves could help reduce stigma and expand community opportunities for persons with severe mental illness.