Integrating family nursing into a busy mental health urgent care setting is a challenge given the high acuity of patients and the demands of delivering service 7 days/week, 14 hours/day. In this article, the authors describe the development of a Mental Health Urgent Care Practice Framework that incorporates four elements: mental health/psychiatric assessment, physical health assessment, family nursing, and integrated behavioral health care. Sample family nursing skills and ladders for mental health urgent care practice are highlighted.The framework and ladders have implications for recruitment and hiring, orientation, peer mentoring, performance appraisals, and continuing education and supervision. A clinical vignette illustrates sample conceptual/ perceptual and executive skills used to apply the framework and ladders in practice. Family nursing is conceptualized as an integral component of nursing care provided to individual and families in this unique setting.