It is well known that many suicidal young people avoid asking for help; however, the reasons why are less understood. A sample of 101 American Indians (age 15-21 years) who had thought about or attempted suicide was asked open-ended questions about barriers to seeking formal and informal help while suicidal. The 74 participants who avoided at least one type of help most commonly reported internal factors, such as embarrassment, lack of problem recognition, a belief that nobody could help, and self-reliance. Structural barriers, such as lack of money or service availability, were only rarely cited. Findings indicate that efforts to increase help seeking among young, suicidal American Indians should target beliefs about emotional problems and help seeking. (Contains 2 tables.)