There are many opportunities for improving mental health in family settings. Programs supporting couples to build better relationships, specific parenting interventions through the period of childbirth and child rearing, and early childhood interventions have all been shown to have significant benefits. In this article the authors outline the negative impact that family disruption, loss and illness, the impact of poverty, disadvantage and violence, may have on the mental health of family members. A positive, preventive approach based on current understandings can support the family in meeting their needs and enhancing their well being.