INTRODUCTION Self-harm behaviour is a global health problem, particularly among children and adolescents but only about a quarter of them have access to health services. It can lead to negative outcomes, including repeated self-harm, suicide and mortality, mental health morbidity and poorer education outcomes. Understanding why adolescents engage in self-harming behaviour is important to improve the effectiveness of clinical interventions. Hence, this study aims to explore the understanding of self-harm and help-seeking behaviours among adolescents attending outpatient psychiatry clinic, Hospital Tengku Ampuan Afzan, Kuantan, Pahang. METHODS Data were collected through in-depth interviews using a semi-structured interview. Recruitment continued until data saturation was achieved. We explored participants’ own experiences during self-harm, their perspectives, psychosocial problems and psychological wellbeing. RESULTS & DISCUSSION Using preliminary data, a total of fourteen adolescents aged 10.4-17.1 years (mean age 15.4, SD = 1.8) were interviewed from the HTAA outpatient psychiatric clinic. There were 13 female participants and one male participant. The majority of the participants were female 13 ( 92.8%) and 1 male (7.1%). The most common methods used by the participant were self-cutting, hitting oneself, scratching with sharp objects, hitting the wall, pulling hair, biting and medication overdose. The majority of participants had underlying clinical diagnosis of Major Depressive Disorder and anxiety disorders. The majority of them had at least one adverse childhood experience (ACE) in their lives. Most of the triggers preceded the self-harm behaviour are emotional distress following arguments with friends, family members and pressure related to school works. CONCLUSION Our findings provide an indication for the improvement of self-harm prevention programmes mainly targeting secondary school students as well as to enhance the delivery of clinical interventions.