The income gradient in childhood mental health: all in the eye of the beholder?

We undertake a detailed statistical investigation of the sensitivity of estimates of the prevalence of childhood mental health problems to the provider of the health assessment, with particular focus on the implications for the estimates of the income gradient in childhood mental health. We directly compare evaluations from children, their parents and teachers and test whether these differences are systematically related to family income. We then examine the implications for the estimated income gradient. We find that respondents frequently identify different children as having a mental health problem. Teachers appear to rate the health of poor children consistently worse than do children or their parents. Systematic differences in evaluations by assessor by income mean that the estimated magnitude and significance of the income-health gradient is highly dependent on the choice of assessor.