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Introduction Narcolepsy is a complex, lifelong illness which impacts significantly on the quality of life of those affected. Mental health issues associated with narcolepsy include depression and anxiety disorders. Consequently, assessment and management of mental health issues is a key part of narcolepsy care. We evaluated the interventions and service innovations led by the Clinical Psychologist for people with narcolepsy attending the Irish National Narcolepsy Centre at St. James’s Hospital over a three year period.Methods We retrospectively assessed interventions undertaken and patient outcomes associated with them via EHR review.Results Three types of intervention were utilised: first, one-to-one therapy using time-limited Cognitive Behavioural and Acceptance and Commitment Therapy frameworks. Second, a six-week Group Therapy for Narcolepsy programme was developed. Finally, a Narcolepsy Information and Support Day model was also developed which included an innovative ‘Hear and Share’ hour where people with narcolepsy described an aspect of their story and supported each other in a confidential group setting.All three interventions lead to a high level of patient attendance and engagement with the service. Qualitative and quantitative outcomes led to the development of a 5-point psychological support plan for people with narcolepsy attending Clinical Psychology at St. James’s: 1. Shifting the goalposts (adjusting expectations and doing what matters), 2. Kind mind (naming challenges, using compassionate mind skills), 3. Tough mind (creating space from unhelpful thinking patterns), 4. Micro habits (controlling the controllable factors), 5. Accepting support (knowing what support is needed and staying connected).Discussion A variety of psychological interventions appear to be helpful and supportive for people with narcolepsy. Future work will prospectively assess the outcomes of psychological interventions in this patient group.