In Reply: Whether to encourage socialization among patients with schizophrenia or, instead, to confront the widespread stigma against mental illness head on and attempt social integration within the larger community is an important question that deserves public debate. Well-intentioned interventions can have unforeseen consequences, such as an increase of births of children whose parents both have a serious mental illness.

Benders-Hadi writes, “Perhaps the development of parenting supports and skills training to assist people with mental illness who choose to parent would be a topic for discussion more useful than questioning the existence of programs that allow for socialization and bonding.” Why limit the discussion? The offerings in rehabilitation programs should probably include genetic psychoeducation (1), contraceptive advice (2), preconception counseling (3), parenting training (4), and staff training to help clients retain custody of their children (5).

To give the children of psychiatric patients the best leg up, their parents deserve excellent comprehensive rehabilitation services, preferably in settings not exclusively determined by diagnosis.