Individuals with SEMH difficulties often perform negative health behaviours, yet little qualitative research aiming to understand why exists. The present study aimed to uncover reasons for poor health behaviours in individuals at an SEMH college. Eight students attending a specialist SEMH college were interviewed about their health behaviours and health beliefs. IPA was utilised to analyse the datasets. Participants seemed aware of the potential severity of ill-health following negative health behaviours, yet this only appeared to influence behaviour when they believed themselves as susceptible to the illness. Coping with adversity and social influence were key barriers in reducing unhealthy behaviours, with perceived barriers outweighing any potential health benefits. Participants expressed good mental wellbeing as key in being physically healthy, both directly and as mediated through health behaviours. Finally, participants engaging in unhealthy behaviours appeared to minimise the potential risks associated with each behaviour. Students with SEMH difficulties perform negative health behaviours for various reasons including social influence, enjoyment and coping with adversity. Addressing these factors may help to improve the health behaviours of this cohort.