Career guidance may have the potential to promote public health by contributing positively to both the prevention of mental health conditions and to population level well-being. The policy implications of this possibility have received little attention. Career guidance agencies are well placed to reach key target groups. Producing persuasive evidence to support claims of health outcomes from guidance is problematic. Although rare, there are some studies of health impacts from employment related interventions, suggesting it is not impossible to generate such evidence. There is a need to develop an evidence base addressing well-being outcomes which may require adopting health-style research methods. There is also a need to open a dialogue with policy makers concerning the potential for career guidance to contribute to public mental health.