The aim of the study was to explore family care givers’ lived experience of the crises that periodically occur in the course of providing care and support for mentally ill relatives. It was undertaken in a rural-urban community in Thailand and many of the participants were involved in subsistence farming while also providing high levels of care and support for relatives with mental illness. The study was undertaken using a hermeneutic phenomenological approach. In-depth audio-taped interviews, using semi-structured open-ended questions, were conducted with 12 consenting participants. Follow-up interviews were undertaken with 10 of the participants originally recruited to the study. Other data collection techniques included the use of note-taking during the interview and maintaining a reflective field journal. Data were subjected to thematic analysis. The results suggested that family care givers in rural-urban Thailand face a number of difficulties and challenges in providing care for their loved ones with mental illness; these include: practical daily struggles, confronting relatives’ worrying and disruptive behaviours, personal social and financial difficulties, and their own troublesome personal lives. The lived experience of care giving for the participants was largely one of ongoing predicament, or crisis, which involved four main themes: ‘Out of control’, ‘So alone’, ‘Confusion and chaos’, and ‘No way out’. Consideration of the lived experience of the participants has highlighted the need for ongoing help and support for family care givers in rural-urban Thailand. It is important that health care providers can recognise and assess the significant burdens associated with family care giving for a relative with mental illness. When care givers face crisis situations it is important that practical help is provided in a timely fashion. Greater emphasis should be placed on improving the mental health literacy of village health care workers in Thailand, through training in basic mental knowledge and skills.