This study explored the understandings of deliberate self-harm (DSH) behaviours, based on the perspective of Pacific health professionals in New Zealand. A total of 20 Pacific informants were interviewed using semi-structured Talanoa methods. Informants held professional roles in the mental health, social and addiction sectors in Auckland, (female, n = 10, male, n = 10). DSH was defined as an intentional act of inflicting harm to the physical, mental or spiritual self, serving separate functions from suicidal intent. DSH was defined to include both direct self-harm as well as indirect forms of self-harm over time such as alcohol and drug misuse, gambling, self-starvation and risk-taking behaviours. Intentional harm to the spiritual or the mental self, included deliberate disconnection from spiritual faith and holding adverse perspectives and worldviews.