Background: Growing up with a severely mentally ill parent can impact on subsequent adult life, and it can be extra challenging in a society with a small population, known as a small-scale society. Life in a small-scale society is characterised by multiple close relationships, lack of anonymity and a conservative attitude towards normal behaviour. Aims: To look at the impact of growing up with a mentally ill parent on adult life in a small-scale society. Methods: Data from semistructured interviews with 11 adult children of severely mentally ill parents were reanalysed and subjected to secondary analysis. Results: The additional analysis resulted in four central themes: ‘becoming open and courageous’, ‘seeking and giving help’, ‘feeling uncertain and different’ and ‘being resilient and sensitive’. These were conflated into an overarching theme: ‘childhood experiences track into adulthood for better and worse’. The themes elucidate a diverse big picture and encompass positive and challenging features of adult life in a small-scale society. Conclusions: The study ends with recommendations for the early establishment of collaboration and family-focused interventions with mentally ill parents and their children.