Children and young people who are classed as Òlooked afterÓ and Òlooked after and accommodatedÓ, have been identified as being especially at risk of self-harm, however there is little research that has assessed self-harm among these groups. This study investigates self-harm rates, distinguishing between cognitions and behaviours with non-suicidal and suicidal intent among the looked after and looked after and accommodated population of young people educated within mainstream institutions in West Central Scotland. Looked after young people who self-harmed were compared with looked after young people who had never self-harmed on reasons for living, self-critical style, common life problems and academic self-esteem. An anonymous self-report questionnaire was used to survey 102 looked after (LAC) and looked after and accommodated (LAAC) children and young people across 10 schools within 6 local authority regions in West Central Scotland that compared self-harmers (n = 32) with those who never self-harmed (n = 70). Thirty-two per cent of the looked after sample reported they had either thought about harming themselves or had actually engaged in self-harm behaviour. Self-harmers (including those who either thought about harming themselves and/or engaged in self-harm) differed from those who had never thought about harming themselves or engaged in self-harm behaviour, with significantly fewer reasons for living (RFL-A) and a more maladaptive self-critical style. The self-critical form of self-hate was found to be particularly important in predicting self-harm (thoughts and behaviours) among this sample of looked after and looked after and accommodated young people. Understanding the factors associated with self-harm and suicide risk is especially important given the already existing vulnerabilities to adverse outcomes associated with being looked after and looked after and accommodated. Strategies for the early identification of maladaptive behaviours among risk groups should take a wider approach beyond those already offered by health services. Utilising knowledge of behaviour and performance within additional key areas of young people’s lives such as education could see a unique school-based intervention that can quickly and easily assess academic-related factors linked with self-harm and offer a strategy for early identification of at risk children and young people.