What is it about the humble little ukulele that makes it one of the most potentially powerful forces for positive mental health and overall well-being that has ever been recognized? One of us is a newly retired nurse, potentially facing all the problems that ageing and retirement have been said to bring; loss of networks, connections, purpose and role and a general decline in physical and mental health (Butterworth et al. 2006). Compound these factors with the Covid years of fear, isolation, lockdowns and anxiety and it is no surprise that increasing loneliness, isolation and loss of human connection are identified in numerous studies and reports about the mental health crises facing all sections of our society, from children and young people (Christiansen et al. 2021) to older adults (Blazer 2020). It is hard to overestimate the dangers of social isolation for mental, physical and wider public health. As Blazer notes:

Nearly 4 decades of research have produced robust evidence that scoring high on measures of social isolation in later life is associated with a significantly increased risk (25%) for premature mortality from all causes in controlled studies. (Blazer 2020; p. 990)

Tackling these social issues is not a job for pharmacology, it is a job for people and communities and the ukulele community is a community in every worthwhile sense of the term. In our combined 90+ years in nursing, we have never encountered such a positive force for engagement, friendship, social inclusion, acceptance, social learning, diversity and unalloyed fun as we have experienced in the ukulele community. The power and health benefits of arts involvement should be no surprise to anyone. For decades now, hospitals and health services have been urged to incorporate an arts plan into their operations. Creative arts and arts participation have been consistently shown to be vital to personal and societal well-being (Allen 2017; Ørjasæter et al. 2018). Many people however consider the arts to be rather elitist and not something that they could ever be involved in. The ukulele upends this notion.

Part of this is due to the ukulele itself. The benefits of music for mental health are long established (Chan et al. 2009; Chang 2018; Stensæth 2018) but some music learning can be intimidating and off-putting (Bannister 2019; p. 66–67), as many children will recall from their piano or violin lessons. The uke is possibly the least intimidating instrument for people to pick up. Total beginners can play a one-fingered C chord, or a ‘chuka-chuka’ ‘Z chord’ with all fingers covering each of the four strings and be strumming a tune within minutes. Ukulele communities have minimal or no ‘entry costs’. Basic ukuleles are very affordable which helps those on low incomes and they can be borrowed free to ‘try out’ from local libraries or uke groups. Ukulele groups everywhere will warmly welcome new members, even if they just ‘come along to see’ or to be part of the social experience.

The benefits of ‘lifelong learning’ and learning new skills, such as playing an instrument are well established (Thibeault & Evoy 2011; Victor Fung & Lehmberg 2016). These benefits are especially pronounced for older people, those with cognitive impairments and those experiencing isolation (Stensæth 2018). Ukulele groups have welcoming and inclusivity in their DNA and demonstrate welcoming, hospitality and acceptance as the profound social practices that they are (Higgins 2020). Any uke group will have members from the widest range of socioeconomic strata and from differing communities, all united in fun and music. As one New Zealand player commented, ‘(We are) people from different backgrounds … and now it’s one sound’ (Bannister 2019; p. 63). They will certainly have members who experience mental and physical health issues in addition to living with loss and bereavement. As one player in Creech’s study noted,

My husband died suddenly over 2 years ago and I found the participation (...) was one of the greatest supports in my life. Singing is always uplifting and it is difficult to be sad while playing the ukulele. (Creech 2011; p. 19)

Uke groups are embedded within their local communities and meet in easily accessed venues such as pubs, clubs, people’s homes, RSL venues and libraries. Their support of their local community facilities is emphatically reciprocated. This is a vital feature of ukulele groups, their deep connection to local areas and communities. There is indeed ‘no place like home’ in preventing loneliness and social isolation.

Ukulele groups and communities are also intergenerational. The uke has been transformed from the perceived crassness of Tiny Tim to the coolness of Zooey Deschanel, Eddie Vedder, Taylor Swift or Billie Eilish and now attracts many younger players. Although most group members may be older people, nobody ever feels out of place in a uke group. The ukulele community practices ‘unconditional positive regard’ without ever having read Carl Rogers. Large egos have no place in a uke group and the warmest applause of a night will often be for the person getting up to ‘have a go’ and play a song for the very first time, absolutely regardless of the virtuosity shown. Ukes are also wonderful solo or ensemble enablers. Whether a person feels most comfortable just strumming on their own or whether they enjoy the camaraderie of playing at whatever level with a small group of friends, they will find a place of acceptance and welcoming in a local ukulele group.

Studies of ukulele groups and ‘community music participation’ worldwide reflect what every ukulele group member has heard a hundred times. Members describe how the uke and its community has enriched and transformed their lives to the point where they could not imagine not having the ukulele or their ‘uke family’ in their lives. As these members noted:

Joining the group has been quite a life-changing experience, meeting wonderful and fun-loving people. (Ellis 2018; p. 117)

Three years ago my husband went into care and I was determined I wasn’t going to sit at home and be miserable, so I thought I might take up music of some sort … I went along and paid my sub and I’ve never regretted it … our little (ukulele) group has become more like a family, because we know each other so well. (Bannister 2019; p. 64)

Members gain confidence, learn new skills, meet new friends, go out and about more, become part of a thriving community and accomplish feats such as performing music live or even writing and playing their own songs, that they might never previously have thought possible. Emmylou Harris once said that ‘As a singer, nothing compares with the joy of adding your voice to those of others’. This encapsulates perfectly the social and community power of ukulele groups where their sum is so much more than the various individuals who take part.

The multi-billion dollar ‘wellness industry’ (Ehrenreich 2018; Pilzer 2012) has debased that term to the level of ‘wellness pornography’ (Remski 2021), social media influencer aesthetics, spas and supplements (Alice 2015; Kirkland 2014; O’Neill 2020). In contrast, the ukulele community practices what ‘wellness’ should be all about, supporting and enhancing the personal, relational and collective dimensions (Ellis 2018; p. 111) of the things that make us flourish as humans and make life enriching and enjoyable.

How the global ukulele community has responded to the covid era of anxiety, lockdowns and enforced isolation has been an object lesson in connection, support, creativity, resilience and care for people. Instead of closing up shop and waiting until the crisis was over, ukulele groups met online, in zoom rooms, in Facebook groups, in ‘bubbles’ and more. There seemed no limit to the creativity and ways that uke groups would keep on strumming and keep all of their members connected, involved and enjoying themselves (Swedberg 2020).

People do not want to be clients of mental health services, they want to be friends and appreciated members of social groups. They would rather go along to social events of their own choosing than wait for appointments for a therapy session. They want to be worked with, not on. They would prefer to be community service providers and members rather than ‘service users’. The rise of ‘social prescribing’ (https://www.economist.com/britain/2018/02/15/tango-classes-ukulele-lessons-the-rise-of-social-prescriptions) is moving public health far from historical ‘medical model’ approaches to promoting and nurturing the kinds of social connections and sense of belonging that people and communities so badly need.

Every community mental health nurse should connect with one of their local ukulele groups and find out how to have a basic ukulele, a tuner, some ‘beginners' playing information’, some easy songs and contact details for local uke groups as part of their clinic or office. Think of it as a mental health first aid kit that could be lent out to clients. It may be premature to discuss ‘uklele-led recovery programmes’ in mental health services, but perhaps it is more timely than we imagine. When Prilleltensky (2005) observed that:

Reactive, individual, alienating, and deficit-based approaches that foster patienthood instead of health, citizenship, and democracy have dominated the field of health and human services for decades. It is time to shift paradigms and give strength-based, preventive, empowering, and community-oriented approaches a chance to promote personal, relational, and collective well-being. (Prilleltensky 2005; p. 59)

he could not have articulated the need for, operation of and value of the ukulele community more clearly.

Fun and enjoyment are rarely discussed or researched in our professional literature. They should be, for as mental health nurses know only too well, people’s lives without them – lives filled with only loss, loneliness, sadness, fragmentation, isolation, anxiety and anomie – can seem bereft and barely liveable. The uklele and the uke community bring happiness, friendship, connection and purpose to people’s lives, for as Creech notes: ‘Above all else, music-making is a joyful and creative activity that all humans, regardless of age, have an entitlement to’. (Creech et al. 2013; p. 98).

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.