Purpose: We sought to not only assess the burden of mental health in San José del Negrito, a community of 1600 in rural Honduras, but also to design and implement a community-based intervention. We applied the community oriented primary care (COPC) model to this low-resource village to (1) measure the prevalence of depression and anxiety, (2) characterize the community’s attitudes and perceptions, (3) develop sustainable, community-centered interventions and (4) monitor the impact of the intervention. Methods: Using the COPC model, we partnered with the village to conduct a comprehensive investigation and develop a locally driven intervention. In 2015, depression and anxiety prevalence rates were calculated from 162 adult responses to Spanish Patient Health Questionnaire-9 (PHQ9) and Generalized Anxiety Disorder-7 (GAD7) questionnaires. In 2016, we conducted focus groups with 19 adults to explore the attitudes and cultural perceptions surrounding mental health. Qualitative analysis using NVivo software identified themes used to inform a two-pronged intervention: a behavioral medicine curriculum for the clinical staff and a ommunity-led stress reduction support group that provides mental health education and peer-to-peer support. Measurements included PHQ9 and GAD7 screenings and surveys of participants’ comfort with the sessions, their perceptions of stigma, feelings of isolation, knowledge, and use of coping skills. Results: The prevalence rates of depression and anxiety are 48% (22.8% endorsed suicidal ideation) and 38%, respectively. Focus group themes included a general concern for acts of suicide, inconsistent definitions of depression, a desire to better understand mental health conditions, negative perceptions of mental health, and preference for using the word “stress” rather than depression or anxiety. Seven women were selected to participate in the first “stress” support group (mean PHQ9 6.4, range 1-14; mean GAD7 6.4, range 1-13). Conclusions: Prevalence rates of depression and anxiety are twice as high in San Jose as the United. Despite the high burden of mental health disease, there is a paucity of mental health care resources, financial support and trained clinical staff. Effective, sustainable solutions to address mental health in low resource settings include capacity building through clinical staff education and engaging the community to provide peer-to-peer support. In the future, the support groups will require ongoing, culturally appropriate modifications to reduce stigma and encourage participation.