It depends.
If someone is suicidal, in addition to self-harming, then I believe they need to get help. If someone comes to you asking for you to help them, then, obviously, they need help, but they just don't know where to get it. If someone was harming themselves and not taking care of their wounds properly, then you might want to get them medical help. If someone just sits down and tells you about their self-harm as friends, then I do think you're betraying them by "telling".
Of course, I have been told on when I was in the latter situation, so I might be biased. I e-mailed a poem to a friend when I was twelve that dealt with self-harm and she asked me if I was self-harming. I didn't want to answer, but her mother must have read her e-mail because the mother wrote a very, very, very long and condescending response that was advising me to get help. Because the mother was a doctor, she had to tell my parents. I felt that was unnecessary. I understand that legally she had to make sure I was "getting help", but I never expressly stated whether or not I was self-harming.
If someone came up to me and was being obviously attention-seeking, flaunting wounds, calling it "cool", or what-have-you, then I would definitely tell. That's just making a mockery of real problems, and telling on them would just give them the attention they want. However, sometimes people refuse to believe you. I was in a situation where I met a guy who was obviously self-harming. I told his older brother, but the brother didn't believe me. I guess I'm kind of glad that my tattling didn't work, because telling does make me feel bad. I feel even more hypocritical because I have been in multiple situations where I have been told on.
Personally, if I was going to tell someone, I would rather tell them myself than have a friend, someone who I trusted to keep things confidential, tell them without my permission. I might keep a friend with me as moral support in case things didn't go well, but I like to make my own choices, especially when it comes to something as personal as self-harm.
I think it's teachers, police officers, and doctors who are required by law to tell your parents/guardians if you confide your self-harming in them. Don't quote me on that, though, I've been wrong before.
In my opinion, it's something different altogether if the person is required to tell or they could lose their liscence. That does put them in an awkward and uncomfortable position, because if you're ever hospitalized for self-harm and you say that you told xxx the police officer/teacher/doctor, then xxx is going to get in big trouble. So, if you're going to share with people in those professions, just be aware of the consequences. Of course, in the situation I said above, where a friend's mother found out, I never meant for her to know.
I just couldn't betray someone who told me -- who gave their trust to me. If I found out and thought that they were either attention-seeking, possibly suicidal, or in need of medical attention, that is completely different. I just think some self-harmers aren't in a position where they are willing to accept help.
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