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Mental illness does not affect only the patient, but is fed from the whole family circle. From this fact stem the broader notions of “family-users” and “patients-users”. Illness is jointly experienced by the family, which in coping develops lay knowledge. Doctors know about illness; families know about handicap. And such knowledge, like all knowledge, works towards change.In order to understand correctly this power of imagination, it is necessary first to describe the situation of the family in mental illness, precisely where lay knowledge is developed. Subsequently, it is necessary to describe the resistance against which it is elaborated: resistance within the care system, including the role of quality management, and resistance in local authorities, which are unavoidable partners in this respect. It will then be possible to take some examples in order to show how families are able to create, in spite of resistance, innovative structures, and to analyse the measures that might be implemented to achieve more in the future.