This chapter explores evolving responses to family (broadly defined to include family of choice) in mental health law. Recognising the complex dialectic at the heart of discussions of family in mental illness, the chapter traces changing views of family in a post-carceral era. Using the example of the ‘Nearest Relative’ framework in the Mental Health Act 1983 (UK), the chapter identifies flaws in responses to family in ‘traditional’ mental health legislation. Some of these flaws are being addressed by recent law reforms which expand the scope for the exercise of individual choice, both through allowing the person to nominate their own supporter/s and through legally enforceable Advance Healthcare Directives. These reforms offer positive options for many people with mental illness and their families. However, there are limits to what these kinds of reforms can deliver. For this reason, the chapter turns to the Report of the Royal Commission into Victoria’s Mental Health System (VRC Report, 2021) which, it argues, offers potential for a more expansive vision of the role of mental health law and new ways of engaging with family.