Objective: Despite recent interest in peer support workers in recovery-oriented services, little is known about how helping behaviors may affect recovery from severe mental illness outside of formal peer support roles. The current study is a mixed-methods approach to understanding naturalistic helping behaviors and their relationship with recovery outcomes among persons with serious mental illness. Methods: Forty-six participants with schizophrenia-spectrum disorders completed a narrative interview and standardized measures of recovery, symptoms, hope, patient activation, quality of life, medication adherence, insight, and illness management. Interviews were coded using emergent, thematic analysis. The study compared individuals who (unprompted) mentioned helping behaviors in their interview to those who did not on recovery-related outcomes. Results: Sixteen participant narratives (35%) described self-initiated helping behaviors. Themes included a desire to tell others their story, teach others recovery-promoting skills, become a peer support worker, give back to society, and be more active family members. Those who discussed helping others in narrative interviews scored significantly higher on measures of recovery, illness management, patient activation, hope, quality of life, medication adherence, and insight and scored significantly lower on measures of overall symptoms, as well as negative, positive, and cognitive symptoms, than did those who did not discuss helping behaviors. The groups did not differ on hostility or emotional discomfort symptoms. Conclusions and Implications for Practice: Findings indicate associations between helping others and improved scores on measures of recovery outcomes. Potential implications include focusing on meaningful work/volunteerism and expanding roles for peer support in recovery-oriented services.