By Netflix’s metric of success, 13 Reasons Why is a huge hit. The 13-episode drama, structured around the narrative of a girl explaining posthumously why she killed herself, is the most tweeted-about show of 2017. It’s also been enormously popular among teen viewers, whom Netflix is eager to hook. Given that the streaming service’s business model values perceived popularity over actual popularity, the record levels of engagement with 13 Reasons Why make it such a surefire winner that the show’s writer’s room was reportedly brainstorming a second season within days of the release of the first.

But the positive buzz around the show has been engulfed in recent days by charges that the show glamorizes suicide: that its graphic portrayal of Hannah Baker’s death is fundamentally irresponsible and could contribute to a contagion effect that leads vulnerable teens—the show’s primary demographic—to end their lives. The National Association of School Psychologists has issued guidelines for educators in talking with students about the show, while the New Zealand Office of Film and Literature has created new standards to advise that under-18s don’t watch the series without adult supervision.

On Wednesday, Netflix announced that it was adding “additional advisories” to the show, including a new warning card at the beginning of the first episode. But the scene of Hannah’s death remains in the final episode, urging the question of how a show themed around such a sensitive subject managed to break virtually every rule in the media playbook when it comes to treatment of suicide—so much so that when a suicide-prevention expert was shown episodes in advance, he reportedly advised Netflix not to release it.

13 Reasons Why was created by Brian Yorkey, a playwright and librettist who received the 2010 Pulitzer Prize for Drama for the musical Next to Normal, which also deals with the subject of mental illness. The series is adapted from the 2007 young-adult novel of the same name by Jay Asher, although it deviates from the book in many ways, particularly in regard to the portrayal of Hannah’s suicide. When the show was in production, a number of mental-health professionals were consulted, including Dr. Rona Hu, a psychiatrist at Stanford Hospital, and Dr. Helen Hsu, a clinical psychologist with the city of Fremont.

Hsu explained to me that she provided feedback on some draft scripts, and on how to portray some of the show’s themes—which include sexual assault, abuse, and addiction—sensitively, but accurately. She emphasized that Hannah’s death had to be portrayed in a way that showed the pain it caused her family and friends, and not in a way that romanticized suicide by making it look serene or pretty. “We had to balance the potential harm of showing it with the potential harm of not showing it, and having it be mysterious or avoidant,” she said.

Nic Sheff, one of the writers on the show, detailed in an op-ed for Vanity Fair why he thought it was vital for 13 Reasons Why to not shy away from depicting Hannah’s suicide. In discussions with other writers, he recounts, he made the case for portraying it honestly by referencing a moment in his life when, after swallowing a number of pills, he remembered a woman describing how horrendous and painful her own suicide attempt had been. “I stand behind what we did 100 percent,” he wrote. “I know it was right, because my own life was saved when the truth of suicide was finally held up for me to see in all its horror—and reality.”

This seems to have been the primary motivation for the show’s treatment of Hannah’s death—that in its ugliness and brutality it would serve as a deterrent to people who might be considering suicide themselves. But this line of thought is directly contradicted by some suicide-prevention experts, who warn about a contagion effect, where the explicit treatment of suicide in media leads to a related increase in suicide attempts. One example is the 1962 death of Marilyn Monroe: After her death was reported in the media as a suicide, suicide rates that month in the U.S. increased by 12 percent.

While studies vary on the extent to which such a contagion effect is felt, suicide-prevention groups have long published media guidelines for tackling the subject responsibly. The British organization The Samaritans advises against publishing precise details about suicide attempts, which can encourage copycat behavior, or over-emphasizing portrayals of grieving family and friends, which can suggest suicide is being honored rather than mourned. It also urges reporters not to include life circumstances that may have been a contributing factor in stories about suicide, since this may cause readers to consider their own similar circumstances equally insurmountable.

13 Reasons Why is a fictional television show, not a news story, but the fact that it’s aimed at teen audiences makes its burden arguably higher. It violates all of the preceding guidelines. Hannah’s suicide is the definitive event around which the show is structured, with each episode targeting a particular person and event that contributed to her decision to take her own life. The grief of her friends and family underpins the series. Her suicide is shown in such explicit detail that it’s extremely hard to watch, unlike in the book, where it’s mentioned only that she “swallowed a handful of pills.” And in another deviation from the book, Hannah’s suicide and the tapes she leaves behind are portrayed as being a force for good in her school community. Her friend Jessica is prompted to talk to her father about her sexual assault. A serial rapist is implicated.

Dr. Dan Reidenberg, the executive director of Suicide Awareness Voices of Education, was asked to review 13 Reasons Why prior to the show’s release. He told me he had a number of concerns about it: “the glamorizing, sensationalizing, memorializing aspects of the series; the violence and brutality; the rape; the failure of reaching out for help; the lack of options and alternatives to Hannah’s suicide; the revenge plot.” Had he been involved earlier, he said, he would have advised producers to do “everything that they can to reduce the risk of copycat behavior and suicide contagion by following safe messaging standards.”

In a previous interview, Reidenberg told Syracuse.com that he advised Netflix not to release the series. He wouldn’t confirm this with me, saying that he wasn’t at liberty to discuss it, and that he preferred to focus on the protection and safety of potential viewers. But he made it clear that he disagreed with the argument that the show has contributed to suicide awareness simply by creating so much exposure around the subject. “It has definitely started a conversation,” he said, “but it hasn’t been the right one, so that is not a success to me.” (A spokesperson for Netflix didn’t reply to interview requests for this story.)

Dr. Hsu counters that the show succeeds overall in the ways it portrays the manifold pressures teens encounter at school. “I’ve spent almost 20 years in clinical work being frustrated to no end at how often adults minimize or deny the real risks and stressors young people experience,” she said. “Not out of malice, but out of sheer ignorance or fear.” She was surprised at the “vehemence” of some of the reactions to the show, and argues that it was meant to be entertainment, not a PSA. Parents are naive, she said, if they think that 13 Reasons Why is the only depiction of suicide that kids can access, and “no one form of media can cause a person to act dangerously unless there are many other existing factors.”

Hsu acknowledges that the 30-minute aftershow that accompanies 13 Reasons Why, Beyond the Reasons, which includes information about suicide-prevention hotlines, could have been presented as a pre-show resource instead, and that more guidelines could have been issued. (Individual episodes don’t include phone numbers or URLs for viewers who might be considering taking their own lives.) But she’s also surprised by the show’s impact. “If young people around the world love it,” she said, “as so many have and keep telling me they do—then I think we as adults need to really sit down with them and listen to what resonates about it.”

While engagement with the show among teen viewers is notably high, it’s drawn criticism from a number of high-profile figures. Paris Jackson, the daughter of the pop star Michael Jackson, republished a damning Tumblr critique of 13 Reasons Why on her Instagram page, calling the series “extremely triggering”:

came across this online and i'm not sure what the source is but this is really important to spread towards people that are struggling with depression or anxiety, self-harm, and or suicidal thoughts. this show was an amazing way to get the message across to bullies that they need to stop doing what they are doing, it really did a good job of showing how impactful words and actions can be to other human beings. you can't just do or say things to people without thinking about how it will affect them. but at the same time it is also an extremely triggering thing to watch. please only watch this show with caution and keep in mind that it may put you in a dark place. if you are struggling please don't watch it. if you think you can handle it, please by all means check it out.

A post shared by Paris-Michael K. Jackson (@parisjackson) on

Car Seat Headrest’s Will Toledo also weighed in on Twitter, saying, “as someone who contributed to the soundtrack for ‘13 Reasons Why’, I am obliged to tell you all that it’s kind of fucked … writers: please don’t tell kids how to turn their miserable and hopeless lives into a thrilling and cathartic suicide mission.”

Contributing to the issues with the show is Netflix’s model. Episodes can be streamed all at once, allowing viewers to immerse themselves in Hannah’s world. Although the show is rated TV-MA to signify that it’s intended for mature audiences, and adults can set parental controls to their Netflix accounts to restrict access, many may have no idea what their children are watching online. And unlike shows on network TV or cable, Netflix isn’t always party to guidelines that might govern its content. In the U.K., for instance, the broadcasting watchdog Ofcom dictates that “methods of suicide and self-harm must not be included in programmes except where they are editorially justified and are also justified by the context.” (In the U.S., the FCC has no similar regulations regarding suicide.) But Netflix, as an internet streaming service, doesn’t have to obey these standards.

The creators of 13 Reasons Why will likely be able to respond to critics with a second season. The final episode of the first seemed to set up a storyline about a school shooting, showing a character who’d been humiliated by his peers stockpiling guns and explosives, and creating a collage of students he saw as his enemies. It’s an equally provocative subject that has similarly in-depth guidelines with regard to how it can be treated responsibly by the media. And it has the potential to be just as influential, and just as divisive.