This international comparative study addresses differences between adolescents who engage in deliberate self-harm (DSH) and who receive help following the DSH episode versus those who do not. A standardized self-report questionnaire was completed by pupils aged 14-17 in Australia, Belgium, England, Hungary, Ireland, The Netherlands, and Norway (n = 30 532). An act of DSH in the year prior to the study was reported by 1660 participants. Nearly half (48.4%) had not received any help following DSH, 32.8% had received help from their social network only and 18.8% from health services. Except for Hungary, cross-national comparisons revealed remarkably similar findings. Adolescents who had been in contact with health services following DSH reported more often a wish to die, lethal methods, alcohol/drug problems and DSH in the family compared to those who had not. However, those who received no help or help from their social network only were also heavily burdened. (Contains 1 figure and 3 tables.)