Urinary incontinence is a common condition. Its prevalence among patients with severe mental illness in acute inpatient settings is significant and often goes unrecognised. Obesity, high caffeine consumption and taking prescribed drugs known to exacerbate or cause incontinence are particular risk factors for this group of patients. The embarrassing and stressful nature of the condition can have a substantial impact on quality of life and limit activities, such as exercise and socialising that are important to both physical and mental health. Using a coaching approach, a 48-year-old woman with severe depression was supported to make simple lifestyle changes to manage her urinary incontinence. Using this approach rather than a traditionally prescriptive form of communication, nurses can combine motivational and emotional support; education, and assistance in accessing resources. The client's own vision is prioritised, leading to improving self-management and long-term outcomes.