Passing is the first point. However, if you can honor the course then it is icing on the cake. Still, the comments made on the clinical evaluation are very important and shouldn't be underestimated.
I think the person who ends up with the straight pass on transcript with outstanding evalutation comments that eventually show up on your Dean's Letter during the application process is as strong if not better than the person who achieved the Honors transcript grade but with moderate or even fair clinical evaluation comments.
With regards to the actual shelf, at my school the mean score is highest for Psychiatry. If your attempts at other shelves are solid, then its quite likely you will score high on the Psychiatry shelf especially because amount of shelf material covered is not as enormous as some other specialties. What will be an obstacle for you is if your school takes into account the standard deviation. Thus your high score may translate into just a "pass" once again.
It's still a buyer's market for Psych although the numbers are likely up this year again. "Top" schools don't necessarily mean top for you. There is tremendous research taking place at many if not most of the traditionally regarded "top" programs which is a heavy criteria for alot of ranking methodologies. You really need to see how each program fits in with your goals of being a strong "clinician" and/or "researcher.