The association between motives for deliberate self-harm (DSH), level of suicide intent, and history of DSH is poorly understood. As part of the WHO/EURO Multicentre Study on Suicidal Behavior, the Suicide Intent Scale, and the Motives for Parasuicide Questionnaire were administered to 146 patients presenting with DSH in the Cork region in Ireland. DSH patients reporting high suicide intent were more motivated to escape from their problem (M = 3.15, p less than 0.001) compared to those with low suicide intent, who were more motivated to appeal to others (M = 1.61, p less than 0.001) and to get a temporary break from their problem (M = 2.47, p less than 0.001). Repeaters more often reported motives aimed at escape (M = 2.98, p less than 0.01), revenge (M = 0.60, p less than 0.005), and appeal (M = 1.43, p = less than 0.05). Self-harming patients are characterized by ambivalence and struggle with aversive thoughts and situations. Therapeutic approaches should include distress management and coping strategies.