The Australian Defence Force (ADF) has conducted mental health screening since the late 1980’s to identify personnel at risk of mental health concerns and provide early, tailored support. Contemporary research, however, raises doubts about the effectiveness of population-level mental health screening in military and other high-risk occupational groups.

Studies show highly variable psychometric performance across screening tools, low treatment initiation rates, under-reporting in employer-administered settings, and minimal evidence that screening reduces prevalence of mental disorders or improves long-term outcomes. Crucially, there is limited research on whether screening leads to sustained engagement with care or improved recovery. Additional challenges include unresolved issues in screening high-risk populations, such as stigma, confidentiality concerns, fear of career consequences, and lack of clarity about what brief screens measure. False-positive rates and optimal clinical thresholds further complicate implementation.

Despite these limitations, the ADF’s approach differs markedly from the narrowly defined “screening” described in the literature. The Mental Health Screening Continuum (MHSC) incorporates psychoeducation, the use of screening instruments and questionnaires, and semi-structured interviews. These elements extend beyond symptom detection, yet they have not been evaluated within existing research frameworks. No studies have assessed the effectiveness, cost-benefit, or long-term outcomes of the MHSC specifically. Ongoing evaluation is essential to ensure that the ADF’s approach delivers genuine benefit for its members and aligns with contemporary mental health and psychosocial risk obligations. This will ensure the MHSC remains evidence-informed, fit for purpose, and free of unintended harms.