Children of parents with a mental illness (COPMI) are at risk of adverse outcomes, as well as of developing a mental illness themselves. Recognition of modifiable risk factors, along with targeted initiatives and interventions have the potential to improve their and their families’ strengths and resilience, and thus effectively interrupt this vicious circle of the transgenerational transmission of mental disorders. Although several international projects have been funded and implemented, their planning, implementation and translation are not free from problems and downsides, and the use of measures specifically targeting COPMI is not yet part of regular clinical practice. Here we illustrate four European projects targeting family mental health, addressing the main problems encountered and the principal focuses for future directions, as learned from live discussions between project team members, participating patients/parents and other stakeholders. Our goal was to summarize those as lessons learned and make them available to the public and research community.