This study investigated factors associated with patient non-compliance with follow-up treatment after a presentation to an Emergency Department (ED) for deliberate self-harm (DSH). 56 patients under 24 years and 20 parents participated in this study. Subjects were interviewed by telephone after they had attended or missed a follow-up appointment following a presentation to an ED for DSH. Convenience of the appointment time and the patients' beliefs about whether counseling would help them were found to differentiate attending and non-attending patients. The attitudes of parents also had a major influence on decisions to attend or not attend an appointment. These results support the use of a therapeutic intervention in the ED, targeting both patients and their parents' attitudes toward counseling.