Self-harm in young people is a complex, persistent problem. Young people who self-harm require supports and resources to address their self-harm, but they are often reluctant to seek help for their self-harm. The rates of self-harm in young people continue to increase despite the extensive research to understand and increase help-seeking in this population. This calls for a paradigm shift in how we understand help-seeking for self-harm. Help-seeking for self-harm needs to be represented as a single unit of analysis, so as to study how its components interact to influence behaviour. We propose that systems thinking frameworks and methods will improve our understanding of help-seeking for self-harm. A systematic review of the existing literature was conducted, synthesising the known facilitators and barriers to help-seeking for self-harm in young people. We applied a well-established systems thinking framework, known as Rasmussen’s Risk Management Framework, to our synthesis. The facilitators and barriers to help-seeking for self-harm from 33 peer-reviewed articles were extracted and mapped onto a ’help-seeking system’ hierarchy, consisting of six levels: (i) Government, (ii) Regulatory bodies and associations, (iii) Local area government and organisation management, (iv) Service delivery and social environment, (v) Individuals and processes, and (vi) Equipment, infrastructure, and surroundings. Our synthesis indicated that there were 17 distinct facilitators of help-seeking, of which many related to service delivery and the social environment of young people. There were twice as many barriers (34 barriers), of which many related to the young people themselves, including their cognitions and feelings towards their self-harm. There was limited consideration of the broader systemic factors that influence help-seeking for self-harm and the interactions between facilitators and/or barriers in influencing help-seeking. The application of systems thinking frameworks and methods can be beneficial, enabling a more holistic and comprehensive understanding of this complex problem.