Soldiers suffering from post-traumatic stress disorder (PTSD) have a personal responsibility to reveal they have a problem so they don't endanger their comrades, Defence Force chief General David Hurley says.
With defence tipped to face a surge in PTSD from operations in Iraq and Afghanistan, General Hurley said foundations were in place to respond.
He said if people with PTSD came forward, they would be treated without career detriment.
"But they need to accept their personal responsibility that they need to be able to do the job," he told a parliamentary committee.
General Hurley said he needed to have confidence in their abilities, as did their subordinates.
"Hiding illness and putting your subordinates at risk is as just as big a sin as me not providing you with the right support. People need to think that through," he said.
"That's a message that probably hasn't gone out strongly enough."
General Hurley said defence had undertaken significant work over the past three years to develop a mental health framework, which includes resilience training and programs for education and treatment.
"The big loophole in all of that is if people don't self-identify, and we can't identify them through the work environment or family reporting and so forth, they will stay out there until they either decide to do that or they take some other sort of action," he said.
General Hurley said retired General John Cantwell, the former commander of Australian forces in the Middle East, gave no hint he had been suffering PTSD since the 1991 Kuwait War.
"He, like many PTSD sufferers, managed to live two lives - one in hell and one publicly," he said.
Head of defence health, Rear Admiral Robyn Walker, said defence screened troops for mental health problems before and after deployment.
But pre-deployment screening wasn't helpful as soldiers wouldn't reveal anything that might stop them going.
More useful was pre-deployment resilience training and screening immediately before departing the area of operations and then again four to six months later.
"That's the time when people will be honest," she said.
"Every military in the world will say that the evidence of doing pre-deployment screening is not worth the paper that it's written on."
