Schools are well-placed to offer support to young people who self-harm. However, research shows that pupils who disclose self-harm behaviour to school staff are often faced with negative reactions and unhelpful responses. There is a clear need for an increased level of knowledge and understanding for staff to respond more appropriately. This study explored the expectations of young people and the needs of staff when responding to self-harm. Twenty semi-structured interviews were conducted with nine young people and 11 school staff. Interviews were analysed using reflexive thematic analysis. Three key themes were identified: (1) Lack of knowledge and confidence to appropriately respond to self-harm (2) Systemic barriers and facilitators to help-seeking in schools and (3) Positive relationships facilitate help-seeking. Young people and staff believe there is an unmet need for training to help staff confidently address self-harm. Future research should involve stakeholders to develop interventions to improve the school response to self-harm.