Surveys have shown that over 90 per cent of the prison population have a diagnosable mental illness, substance abuse problem, or both (ONS 1998). There is general agreement that although there are areas where practice is excellent, practice is not consistent across England and Wales, and often does not equate to standards in the NHS. In 2001 the Department of Health and the prison service set out their joint approach to the modernisation of mental health services in prisons (DoH 2001), and proposed mental health in-reach as a means of improving services and achieving the objectives of the NHS Plan (DoH 2000). This article looks at the one of the first prison in-reach services that was launched at HMP Leicester early in 2002, and considers the effect these nurses have had on the care of mentally ill adults at the prison. A case study outlining the in-reach team’s approach to one of the prison’s greatest challenges, self-harm, is also included.