SAN FRANCISCO — Though it once took a back seat to workplace programs focused on the physical and financial aspects of worker health, behavioral health has emerged as the new frontier of employee wellness.

Employers are recognizing behavioral health — which encompasses mental, emotional and spiritual health — as an essential piece of a healthy culture and a way to improve business performance while saving on health care costs.

Employers such as Michelin North America Inc., Johnson & Johnson, and Comcast Corp. are making mental health and wellness part of the workplace culture by giving employees the tools they need to combat depression, anxiety and stress, as well as tackle issues like substance abuse and alcoholism.

“Twenty years ago, we did not talk about behavioral health at all,” Rich Paul, Raleigh, North Carolina-based senior vice president of employer strategy and development with Boston-based employee assistance program provider Beacon Health Options, said during a session at the Integrated Benefits Institute's annual forum in San Francisco Feb. 15-17. “We are certainly talking about it now, and the impact that behavioral health has on all aspects of employer costs.”

For instance, the behavioral health initiatives of Greenville, South Carolina-based tire manufacturer Michelin have led to a 30% reduction in related outpatient claims spending, according to Jim West, manager of Michelin's behavioral health program, Michelin Employee Life Services.

The program is a “one-stop shop” that puts its employee assistance program front and center in every wellness initiative, Mr. West said during the IBI forum.

Run by Beacon, the program has EAP counselors in its on-site health centers, a digital cognitive behavioral therapy tool and telepsychiatry services for its campuses in areas with a shortage of psychiatrists.

Michelin's health risk assessment asks questions to identify employees' risks for alcoholism and substance abuse, with special interventions at locations with high scores, Mr. West said.

Overall utilization of Michelin's EAP was 19% in 2014, and the company's behavioral health program boasts a return on investment of 182%, Mr. West said.

One reason mental health is moving to the forefront is because it's becoming easier to talk about, several speakers at the forum said. “We're starting to see more leaders within organizations really talk about behavioral health, talk about stigma associated with mental health, and then also thinking strategically and creatively around how to reduce stigma in order to increase help-seeking behavior,” Mr. Paul said.

The economic burden of behavioral health issues is hefty: Workplace stress alone contributes between $125 billion and $190 billion to health care costs annually, or 5% to 8% of national spending on health care, according to a January 2015 paper by researchers at Harvard Business School in Boston, and the Stanford Graduate School of Business in California.

Depression, the leading cause of disability for U.S. adults ages 15-44, results in nearly 400 million disability days per year, according to a study published in the February 2015 issue of the Journal of Clinical Psychiatry.

Employers incur an estimated $100 billion annually in direct and indirect costs associated with depression, including as much as $44 billion lost to employee absences and lower productivity, according to a survey published in 2014 by Employers Health Coalition Inc., a Canton, Ohio-based nonprofit health benefits service provider.

According to Dr. Fikry Isaac, chief medical officer of health and wellness solutions at New Brunswick, New Jersey-based Johnson & Johnson, the business case for behavioral health is clear.

“Organizations that engage employees in their health do have a competitive advantage,” he said in a separate session, adding that increased productivity, attraction and retention are benefits of behavioral health programs.

Still, there are hurdles to implementing mental health initiatives in the workplace, and Patricia Purdy, vice president of global employer solutions at Chicago-based employee benefits advisory firm Pacific Resources Benefits Advisors L.L.C., said many employers are “woefully behind.”

For one, Ms. Purdy said, there's the question of how you label such a program to be broad and nonthreatening. “Do we call it mental illness, mental wellness, mental well-being, behavioral well-being?” she asked.

Dr. Robert Carr, director of the executive master's program in health systems administration at Georgetown University, Washington, and former corporate medical director with GlaxoSmithKline P.L.C., said it's important not to treat behavioral health as a “medical condition” but as a “competency” that you help employees strengthen.

“It's a way of processing, a way of thinking, a way of dealing with your life that allows you to have a stronger mental well-being,” he said.

And stigma can't be overlooked, as it may prevent employees from coming forward for help.

“We always talk about stigma, but we don't do much about it,” said Dr. Isaac.

“The conversation needs to change,” he said. “It's the whole person. It is a holistic approach to health. Mental, emotional, spiritual well-being is part of the bigger picture as it relates to the workforce for the future, and I think we need to really change it into that mindset.”