This chapter presents a multilevel prevention framework for addressing the complex behavioral health needs of firefighters. Using primary, secondary, tertiary, and quaternary prevention models, it outlines how resilience-building, early identification, evidence-based treatment, and protection against overmedicalization can be integrated into fire service systems. The chapter emphasizes that effective prevention requires both individual engagement, particularly through constructs like locus of control, and organizational commitment to psychological safety, peer support, and culturally competent care. It also critiques the limitations of generalized mental health systems, such as Employee Assistance Programs (EAPs), and argues for structural reform to enhance provider quality and occupational relevance. Substance use prevention is explored through evidence-based strategies adapted from other high-risk professions, reinforcing the need for a culturally attuned, systemic, and science-informed approach to fire service mental health and readiness.