This image, released by Netflix, shows Katherine Langford in a scene from the series "13 Reasons Why," about a teenager who commits suicide. Educators and school mental health professionals have been deeply concerned about the impact on young people who view the series. (Beth Dubber/AP)

Educators and school mental health professionals across the country are warning parents about the Netflix series “13 Reasons Why,” saying the show’s graphic depiction of a teenager’s suicide could contribute to a “contagion effect” among students with mental illness and linking it to self-harm and suicide threats among young people.

The show has prompted a major response from educators and administrators, who have spoken at PTA meetings, sent messages home and even cautioned certain groups of students about whether to watch it at all.

“There’s no room for error when it comes to student wellness,” said Rebecca Aguilar, who oversees school counselors at Thoreau Middle School in Fairfax County, where school officials sent home a list of talking points advising parents about the show. She recommends that parents “stay engaged with your children. And if they are watching it, process it with them.”

Robert M. Avossa, superintendent of Palm Beach County schools in Florida, told parents that school personnel had seen a rise in the number of students who have hurt themselves and threatened suicide.

“As a father of a teenager and tween, I am very concerned about a dangerous trend we have observed in our schools in recent days,” Avossa wrote. “School District personnel have observed an increase in youth at-risk behavior at the elementary and middle school levels to include self-mutilation, threats of suicide, and multiple Baker Act incidents,” referring to a Florida law that allows people to be involuntarily committed. “Students involved in the recent incidents have articulated associations of their at­-risk behavior to the ‘13 Reasons Why’ Netflix series,” she wrote.

(Mayo Clinic)

A Netflix spokesman said in a statement that the company has heard that the show has “opened up a dialogue” about the intense themes depicted in it. Netflix said it added explicit warnings to the three most graphic episodes and is adding another warning before the first episode. The statement said it also produced a behind-the-scenes documentary about the show called “Behind the Reasons.” In it, the actors and creators indicate they consulted with mental health professionals on some aspects of the show.

“Entertainment has always been the ultimate connector and we hope that ‘13 Reasons Why’ can serve as a catalyst for conversation,” Netflix said.

The National Association of School Psychologists sent a notice to school mental health professionals across the country on how to talk about the show. A spokeswoman said it was the first time the association has put out guidance in response to a television show.

“Across the suicide-prevention communities and experts, there is concern in the way that the suicide is portrayed and the buildup to the suicide . . . could trigger suicide contagion or copycat behavior,” said Kathy Cowan, the spokeswoman.

Suicide was the second-leading cause of death for teens in 2014, according to the Centers for Disease Control and Prevention, although it is still relatively rare. But recent attention on the issue has prompted schools to step up their suicide-prevention efforts, focusing on screening students to uncover potential mental health issues and urging students to talk to adults when they are worried about a classmate.

The guidance, posted on the association’s website, advises some children not to watch the series.

“We do not recommend that vulnerable youth, especially those who have any degree of suicidal ideation, watch this series,” the association said. “Its powerful storytelling may lead impressionable viewers to romanticize the choices made by the characters and/or develop revenge fantasies.”

The show traces the perils and eventual suicide of a teenager named Hannah and is based on a young adult novel of the same title. In the opening episode, viewers learn that Hannah has committed suicide. Before her death, she sent 13 cassette tapes to friends and acquaintances, explaining in detail how they contributed to her downfall. The show toggles between life after Hannah’s suicide, as her grieving peers struggle to untangle the reasons she ended her life, and Hannah’s tortured adolescence, when she becomes the victim of vicious rumors, cyberbullying, a sexual assault and an incompetent school counselor. It ends with the graphic portrayal of her suicide.

Mental health professionals have criticized the show for several reasons, saying it romanticizes suicide and inspires teens to imagine what could happen after their own death. In reality, experts say it is often mental illness and stressors that lead to suicide, although the show does not touch upon whether Hannah has mental illness. In the show, Hannah’s suicide is a means to exact revenge against the people she felt wronged her.

“It implies throughout the show that she actually gets revenge, [that] she has an impact on the people she leaves behind in a way that you can’t really guarantee with suicide,” Cowan said.

But critics have been most galled by the show’s portrayal of a school counselor, who brushes off Hannah when she relays to him that she has been sexually assaulted and urges her to move on.

“That’s unethical behavior. School mental health professionals do not behave that way,” Cowan said. “It sends the message that school mental professionals are not a trusted source for help. And all kids need to know that adults are there to help them and they can be trusted.”

Rida Ali, 16, a junior at Broad Run High in Loudoun County, said she was immediately sucked in by the show, taking in all 13 episodes in less than a week after seeing friends talk about it on Twitter. Loudoun schools put out a note to parents about the series and linked to the NASP’s guidance.

Ali credited the creators for getting some aspects of adolescent life right: the pernicious nature of cyberbullying — where an embarrassing photo or missive can be shared with the world via Snapchat and group text messages — the apocalyptic sense of dread that comes with being embarrassed or shamed, and the way that young men scrutinize the bodies of their female classmates.

Ali said she worries teens will watch the show and view Hannah’s choice to end her own life as a logical solution to her perils rather than sending the message that there were other options.

“I feel like it was kind of saying that she was right . . . like, ‘This is justified,’ ” said Ali. “You have to try. You have to keep going, and it will be hard but know that someone out there cares for you. I feel like they should have that message.”

Valerie Strauss contributed to this report.