Among college students in the United States nationally, non-suicidal self-injurious (NSSI) behaviors have become alarmingly and increasingly common. Among those willing to disclose, recent estimates indicate 25-30% engaged in NSSI in 2020 alone. Prevalence is significantly elevated among students who identify as a sexual minority (i.e., lesbian, gay, bisexual, queer/questioning, etc. [LGBQ[plus]]), with estimates indicating an average of 40% of these students reporting NSSI. However, escalation in severity and prevalence over the last decade has been accompanied by stagnant, low rates of help-seeking among these students, who appear to only be willing to disclose and pursue formal treatment upon experiencing severe distress and suicidality. A review of the existing literature revealed internalized stigma as a key variable that appears to explain both the escalation in self-harm engagement and lack of willingness to seek support. Several gaps in the literature were also identified, including: (1) lack of an expansive, inclusive definition of self-harm, (2) lack of inclusion of self-harm and sexual orientation as variables of interest in nationally-representative research investigating college student help-seeking attitudes and behavior, and (3) lack of investigation into the influence of different types of internalized stigma on the relationship between self-harm and help-seeking, including stigma directly related to self-harm behavior and stigma related to sexual orientation. This study employed a correlational analysis approach to understanding relationships between the study's key variables, including psychological distress, severity of self-harm engagement, willingness to seek psychological help, and three distinct types of internalized stigma: internalized stigma of mental illness (ISMI), internalized stigma of self-harm (ISSH), and internalized heterosexism (IH). The three variables of internalized stigma and severity of self-harm engagement were also investigated for their ability to predict willingness to seek psychological help. A sample of college students (n = 302), recruited via the online crowdsourcing platform Amazon's Mechanical Turk (MTurk), completed a brief self-report survey of their experience. Measures included the Kessler 10-item Psychological Distress Scale (K-10), the Non-Suicidal Self-Injury Assessment Tool (NSSI-AT), the Internalized Stigma of Mental Illness Inventory-10 (ISMI-10), the Self-Injury Social Reactions Questionnaire (SI-SRQ), the Sexual Identity Distress Scale (SIDS), and the Attitudes Toward Seeking Professional Psychological Help Scale-Short Form (ATSPPH-SF). Results of correlational and regression analyses indicated that internalized stigma and severity of self-harm engagement were significantly associated with willingness to seek psychological help among this sample. In the overall sample, which included students with and without self-harm engagement, ISMI was the most significant predictor of willingness to seek help, regardless of sexual orientation. However, among students who did engage in self-harm, at any level of severity, the severity of their self-harm was the predominant predictor of their willingness to seek formal psychological help, over and above the effects of internalized stigma. Results also supported significant relationships between ISMI, ISSH, and IH among the target sample of participants who identify with all three of these minority identities: mental illness, self-harm engagement, and LGBQ[plus] identity. Among LGBQ[plus] students, self-harm severity was additionally related to IH, such that those with greater IH reported more severe self-harm. Surprisingly, when measured dichotomously between heterosexual and LGBQ[plus] students, no significant differences in severity, internalized stigma, or help-seeking willingness were found between students based on sexual orientation. Additionally, psychological distress was found to be unrelated to any other variable of interest. These findings support the existing literature that self-harm is prevalent and severe among college students, and add to the literature by demonstrating that internalized stigma and increasing severity of self-harm explain students' reluctance to seek the help of formal psychological services. As such, it is imperative that clinicians and other professionals who serve these students are prepared to competently, and compassionately, evaluate and treat severe self-harm engagement, in order to reduce the likelihood of amplifying the effects of internalized stigma that prevent students from seeking help initially. Among other recommendations, results implicate future research to: (1) define self-harm utilizing a comprehensive, evaluative approach that does not require participants to self-identify and label their behavior, (2) further investigate internalized stigma as a barrier to help-seeking utilizing a multi-faceted definition that separately measures stigma related to various minority identities, including specifically toward self-harm engagement and LGBQ[plus] identity, (3) further analyze internalized stigma as a co-variate in courses of illness that include self-harm engagement, and (4) explore the efficacy of interventions designed to reduce internalized stigma (toward mental illness, self-harm engagement, and LGBQ[plus] identity) for their ability to potentially reduce self-harm severity, increase willingness to seek formal psychological help, and increase service utilization. [The dissertation citations contained here are published with the permission of ProQuest LLC. 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