Suicide and deliberate self-harm (DSH) among young people are critical public health concerns both globally and in Sri Lanka. While most studies focus on risk factors, less attention has been given to family responses to youth engaging in self-harm, despite the crucial role of family support in preventing repeated self-harm. This qualitative study applies the constructive grounded theory approach to explore family reactions to young people following self-harm. Analysis of 40 in-depth interviews identified four major themes: (1) the family's aftercare role, (2) family accusation and reduced communication, (3) recalling unpleasant memories, and (4) withdrawal of family support. Findings reveal that while families provide some level of care, negative responses can undermine the psychosocial well-being of affected youth in the post-hospitalization period. The study highlights the need for interventions focusing on strengthening family relationships and psychoeducation to minimize negative family reactions.