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This article uses aspects from Institutional Ethnography to explore how both clinicians and young adults with mental health problems use different adaptation strategies to overcome the diagnostic uncertainty in psychiatry. The article illustrates the connection between the local production of diagnoses in Norwegian psychiatric outpatient clinics and the individual experience of being identified with multiple psychiatric diagnoses. The article explores how two clinicians from two psychiatric outpatient clinics produce diagnoses locally. It is shown how institutional texts coordinate the diagnostic work as ‘ruling relations’. On the other side of the desk, the arbitrary element affects the young adults with mental health problems, who perform a large amount of identity work when dealing with the numerous diagnoses they are given. The young adults find the ease with which they are diagnosed, the number of diagnoses, and the way the diagnoses are used to be disturbing and confusing.

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