Abstract
<title>Abstract</title> <p>Background: Depression-related stigma remains a major barrier to mental health care among older adults, particularly in rural settings. Interventions combining mental health literacy and behavioural approaches may reduce stigma and improve knowledge. Methods: A quasi-experimental pretest–post-test control-group design was used. Sixty elderly participants (≥ 60 years) with moderate-to-high levels of depression-related stigma were selected through purposive sampling and allocated to an experimental group (n = 30) and a control group (n = 30). The experimental group received three depression literacy sessions followed by six weekly group-based behavioural therapy sessions. The control group received routine community health education. Depression Stigma Scale (personal and perceived stigma) and the Depression Literacy Questionnaire were used. Paired t-tests, Mann–Whitney U tests, and Chi-square tests were applied. Effect size was calculated using Cohen’s d. A p-value < 0.05 was considered statistically significant. Results: At baseline, depression-related stigma scores were significantly higher in the experimental group compared to the control group (p = 0.016). Following the intervention, the experimental group showed a significant reduction in stigma scores from 39.86 ± 5.42 to 33.94 ± 7.65 (t(29) = 2.970, p = 0.006), whereas no significant change was observed in the control group (p = 0.815). Significant reductions were also observed in personal stigma (p = 0.008) and perceived stigma (p = 0.033). Depression literacy scores improved significantly in the experimental group from 28.5 ± 8.8 to 35.9 ± 10.5 (p = 0.007). The intervention demonstrated a large effect size (Cohen’s d = 0.894), indicating substantial practical impact. Conclusion: The combined depression literacy and group-based behavioural therapy intervention was effective in reducing personal stigma and perceived stigma. This culturally adapted, community-based model is feasible for use in low-resource settings and can be integrated into primary healthcare to improve mental health outcomes in older populations. Trial Registration Not applicable (As the ethical approval for our study was obtained more than one year ago. As per the current CTRI guidelines and procedural limitations, retrospective registration is presently not feasible for our study. )</p>