Hi B.,
I totally feel for you and your daughter... her pain is your pain.
When your daughter is in the psych unit-- how long is she usually there? If it's one of those things where she goes in for 3 days, or up to a week or so-- that's just not going to cut it. All they're doing is monitoring her, making sure she's not suicidal, and checking her doses for meds. They might have her talking to therapists, or in group sessions, but she's not getting the constant care and structure she probably needs. Then she's back home with you and nothing's been done to REALLY help her.
You may want to consider seeking residential treatment for her. She's has an awful lot of diagnosis-- an honestly, I'm wondering how correct they are. Unless she's been in residential treatment for a signficant enough amount of time to be really observed, I'm suspicious that you may have a doctor who's just piling on diagnosis without doing proper eval. That's where residential treatment may be helpful.
It's a hard thing to do, but 6 months to a year, or maybe more, (depending on how quickly she responds to treatment and regains control) with re-evaluation of diagnosis' and meds--intensive monitoring by doctors, psychotherapists, effective recreation therapy, structure, on campus schooling, etc may be exactly what she needs.
And considering that she's hurting herself and is so out of control, you have to worry that she's going to influence or even hurt her younger sister.
It's terribly expensive out of pocket-- so you'd have to talk to her doctors, psychiatrists, the people at Mental Health Services,etc, and see if they can get her in a residential situation.
My mother is the head nurse at a center like this--
they have a board of doctors, therapists, counselors, etc and the first thing they do is go over her history, monitor her behavior, the efficacy of her meds, do testing etc, and make sure she has the correct diagnosis'. About 7 to 8 times out of ten, they end up changing diagnosis-- the kids haven't been sufficiently examined over a long enough period of time. The kid's doctors back home often do an interview or two, listen to parent or teacher complaints and descriptions of behaviors, try a med, and if it looks like it works-- bam, they make a diagnosis. But a good solid psych diagnosis takes much more than that. It takes personal, professional observation and monitoring over a substantial amount of time.
Once they have correct diagnosis', they can treat them with meds, therapies and counseling that really work.
Check out the site of the center she works for-- it will give you an idea of what places like this can offer and how they help. This center is in Utah-- but I'm sure someone at Mental Health services or a good psychiatrist could recommend other places in Missouri or Kansas that are similar.
www.heritagertc.org
Best wishes!
T.