Introduction: Living with a parent with mental illness can bring up unique challenges. Children living with parental mental illness are considered a high-risk group for developing mental illness. The purpose of the study was to explore the perceptions of adult offspring of a parent with severe mental illness (SMI) on the needs of children (0-18 years). Methods: We conducted five in-depth interviews with young caregivers aged between 19 and 25 years with a parent diagnosed with SMI, receiving treatment from a tertiary mental health institute in Assam, Northeast India. Based on their experience of growing up as a child of a parent with SMI, they were asked to reflect on the needs of children whose parent has been diagnosed with a mental illness. Atlas Ti software was used to generate codes and for thematic analysis. Results: Findings are discussed under the following five themes: (i) Support towards managing early responsibilities, (ii) Managing normal education and life trajectories, (iii) Stigma and its role in their lives, (iv) Enhancement of knowledge of parental mental illness, and (v) Management of Distress. Conclusion: Our findings underscore the need to include the perspectives of child/young adult caregivers in family interventions to address their needs and support comprehensive mental health service delivery.