The visit with the pediatric psychiatrist was a profitable one, really. She's a good doctor with a level head.
She prescribed a new sleep med and an increase in the dose of one of her current mood-stabilizer meds. And she recommended we go ahead and begin the process of applying for a spot at a residential treatment facility, since they have waiting lists.
Here we go. Oddly, I feel a little bit relieved this afternoon. We won't be doing the same old thing and expecting or hoping for better results. She's not going back to school in her current classes; she will go into the behavior-disorder classroom full time and do her classes online. She will have very limited - read "NO" - contact with the current crop of friends, mainly because she just can't handle it. And as soon as a spot opens up in one of the treatment facilities, she'll go live there long-term. Dunno how soon that will be. Or if we'll be able to afford it... or whether we can afford NOT to.