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It's a scene as painful to watch as it is graphic: A 17-year-old girl climbs into a full bathtub with a razor. We see her slice into her skin, we see the blood pour out, hear her cry and struggle to breathe. Then she is still.
The suicide of the heroine in Netflix's new popular series "13 Reasons Why" shouldn't come as a shock, since it's depicted in the final episode of a series built around the character's death. But knowing that it is coming doesn't make it any easier.
That stomach-turning scene has triggered criticism that it romanticizes suicide and prompted many schools across the country to send warning letters to parents and guardians. The show's creators are unapologetic, saying their frank depiction needs to be "unflinching and raw."
"Many people are accusing the show of glamorizing suicide and I feel strongly and I think everyone who made the show feel very strongly that we did the exact opposite," said writer Brian Yorkey, who won a Tony Award and a Pulitzer Prize for the stage play "Next to Normal," which grappled with mental illness. "What we did was portray suicide and we portrayed it as very ugly and very damaging."
The 13-episode drama, co-produced by actor and singer Selena Gomez, is based on Jay Asher's young-adult 2007 best-seller about a high-school student who kills herself and leaves behind 13 audiotapes detailing the events that led to her death, including sexual assault, substance abuse and bullying.
Per usual, Netflix released all 13 hours of the series at once on March 31 leaving suicide-prevention specialists worried teens might binge the entire series without a chance to fully absorb the issues and ask questions. They also say they wish the show would consistently flash the National Suicide Prevention hotline.
"Graphic details about suicide we know historically are not recommended," said Phyllis Alongi, the clinical director of The Society for the Prevention of Teen Suicide. "I understand what the producers are saying, but it could really be unsafe, and I think we need to be a little more responsible."
Netflix and the show creators point out that several mental-health professionals were consulted and they offer a 30- minute show called "Beyond the Reasons" that delves deeper into the tougher topics portrayed, as well as links to a site with resources.
The show is rated TV-MA, which means it may be unsuitable for children under 17, and three episodes that contain explicit material have "viewer discretion advised" warnings.
But some mental-health professionals are going further, with the National Association of School Psychologists declaring, "We do not recommend that vulnerable youth, especially those who have any degree of suicidal ideation, watch this series."
Critics of the show argue that depression and mental illness keys to understanding suicide are rarely mentioned and the fact that its heroine, Hannah, gets to tell her story after her death sends a potentially dangerous message. They're also upset that the school guidance counselor depicted on the show seems to blame the victim.
The Jed Foundation and Suicide Awareness Voices of Education joined forces to create 13 talking points for young adults and guardians to discuss while watching the series, including warnings that the way the counselor is portrayed is "not typical" and that "leaving messages from beyond the grave is a dramatization produced in Hollywood."
School systems across the country are alerting parents, making them aware that their teens may be streaming the series, urging them to watch it with them and providing information to help them talk about it.
In the upstate New York community of Grand Island, school administrators warned that the series "sensationalizes suicide." Indiana's largest school district warned in an email that the series "does not accurately model what we would want or hope individuals do if they are struggling or in crisis."
In Maryland, principals in the Montgomery County public school system noticed teens talking about the series and wanted to make sure parents had resources to handle tough questions. A warning letter and links to resources eventually went out to all 35,000 middle schoolers.
"There's a lot to take in and digest. If you're a young, growing mind being informed by what you see, this could have an impact," said Derek Turner, spokesman for the district. "So we're giving them tips and tools."
According to the Centers for Disease Control and Prevention, suicide was the second leading cause of death for children and young adults ages 10 to 24 in 2014.
Helen Hsu, a clinical psychologist in Fremont, Calif., whose work involves suicide prevention in schools, helped shape some of the "13 Reasons Why" scripts. She said not showing Hannah's suicide would be almost "coy and avoidant" and that medical studies aren't definitive about the risks of suicide contagion. Plus, there are already graphic how-to guides online.
"If you think your child can't find this in 1 second on the internet already in the past 10 years, you are sadly mistaken," she said. "To say this is going to trigger that is sort of naive. What I really emphasized in the script writing was I said, 'It has to focus on that it's not glamorous, that it's ugly, it's painful and I really want you to focus on the pain of her parents and the people left.' "
While suicide has been depicted on TV shows, the youth of the roles in "13 Reasons Why" is pioneering. It has clearly struck a nerve: The show has 340,000 Twitter followers and 2.4 million likes on Facebook.
Gomez, who has talked openly about her own mental-health struggles, said she was braced for a backlash: "It's going to come no matter what. It's not an easy subject to talk about. But I'm very fortunate with how it's doing."
Yorkey said creators wanted to tell a young-adult story in "a more honest way than it has ever been told on television."
"I understand it's hard to watch," he said. "It was supposed to be hard to watch because these things are incredibly hard to endure and we wanted to say, 'These things are happening in kids' lives. You can keep quiet about them. You can keep kids from watching shows about them. It's not going to stop them from happening in kids' lives and you should be talking about that.' "