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The Parsons State Insane Asylum is a location in the Commonwealth in 2287.


Built by the Cabot family and formerly administered by their son Jack, the superintendent, the Parsons State Insane Asylum housed and cared for Boston area residents who were deemed mentally ill or insane. Subterranean rooms were constructed in the facility's basement to house the most difficult cases, including Lorenzo Cabot.[1] Lorenzo was institutionalized for life[2] at the asylum for the safety of him and his family, following an 1894 archaeological expedition in the Middle East to find the lost city of Ubar. The trip uncovered a mysterious artifact that bestowed upon him supernatural powers, but also made him mentally unstable, resulting in his admittance to the institution.[3]

In the years following the Great War, the Cabots hired a security team to protect Lorenzo and his secrets from exploitation by outsiders.



The grounds are fairly mundane, notable only for a few mercenaries roaming around. A road leading in from the northeast passes by the administration entrance, the only way into the asylum. A wall surrounds the grounds, but some sections have crumbled over the years. Around the back of asylum is an outdoor area where patients could get some fresh air.


The interior of the asylum is not accessible until The Secret of Cabot House becomes available. The door to administration opens to an admissions area, with two initially locked doors. The open hallway to the northwest contains a few wrecked offices and ends in a staircase leading upstairs. At the end of the upstairs hallway is a supply room with a busted wall, allowing passage.

This leads to a staircase leading down to the main floor again, toward one of the initially locked doors. The hallway on the main floor leads into an office containing an elevator. Through the north-facing door is a pavilion with a fountain in the center. Scaffolding leads up to a hole in the wall giving access to a therapy room. Through the door is the rest of the insane asylum.

The room opens to an expansive room that hooks around to a kitchen area. The collapsed floor leads down to a common room connected to a few offices. Through another hole in the wall, one enters the spacing between some walls and can descend into the basement. The basement is lined with several small rooms containing only a bed, dresser and toilet, like for the more unstable patients. A hole in the floor at the end of the hallways leads to a few more solitary rooms; the hallway ends at a utility elevator that takes one to the basement.

The basement contains the control room to Lorenzo Cabot's personal prison cell, which is surrounded by generators and an Abremalin field. Inside is a bed, a chair, some tables, a curio and Lorenzo himself. An elevator in the control room leaves back up to the ground floor.


Notable loot

  • Charisma bobblehead - In the administration area, on the desk in the room with the elevator (Jack Cabot's office).
  • Cell key - In two file cabinets in the administration area: one in the large room near the exit, the other in a corner by Jack's office desk.
  • A Syringer rifle - In the last room on the left at the end of the block of cells in the basement (across from the cell with the collapsed floor through which you must fall to find where Lorenzo is held captive).
  • Mysterious serum - There is one vial of serum next to a raider in the very first room entered. Four syringes are in Lefty's inventory and three more are on a surgical tray on a table in the room containing Lorenzo's cell.
  • Three overdue books - The first book is inside an open filing cabinet which is on the west side, furthest away, of the very first room you reach after taking the elevator down. The second and third books are both in the control room. When entering the control room, walk straight to the filing cabinets ahead to find the second book in an open drawer. The final book is in a loose drawer above and to the left of where the second book was. It can be grabbed by jumping on the storage crates.
  • Massachusetts Surgical Journal issue #16 - On a table in Lorenzo's cell (possibly hidden beneath a vase).
  • Lorenzo's suit - On Lorenzo Cabot's body, if one kills him during the Secret of Cabot House.
  • Lorenzo's Artifact gun - Reward for The Secret of Cabot House given by siding with Jack and then waiting one in-game week.
  • Two Vault-Tec lunchboxes - The first is on a bench in the same hallway as the first raiders encountered. The second is on a shelf in the room just before the control room.

Related quests


  • The interior can only be accessed during the mission The Secret of Cabot House. To begin this quest line the Sole Survivor must meet with Edward Deegan, who spawns at Bunker Hill, the Third Rail or Dugout Inn, or travel directly to the Cabot house and pass two speech checks to be allowed inside. After talking with Edward, he will give the player character an objective to meet Jack Cabot at the Cabot house. Following a talk with Edward and Jack, they will give the quest Special Delivery. After the completion of Special Delivery, more quests are given until the quest The Secret of Cabot House is given which is the last quest in the chain.
  • In one of the cells there are four question marks, one straight line, and two squiggly lines chalked on the wall along with the message HELP ME.
  • Wooden blocks forming the words CRAZY can be found on a wooden bench in the corridor leading east when entering from the main door.
  • The corpses of dead raiders and mercenaries killed around the entrance during the quest here do not despawn even after many days have passed. On returning there are often one or two raiders outside the entrance.
  • One may be given this location on the Pip-Boy map by a settler at Greentop Nursery. As the settler is approached, they say "the Parsons State Insane Asylum should be avoided." The map marker is then added to the Pip-Boy.
  • There is possibly a reference to a nursery rhyme, "5 little monkeys jumping on a bed" (there is a room with 2 monkeys still on a bed and 3 off).
  • In the same room as the monkeys, there are 2 wooden blocks saying "FU."
  • If you attack the mercenaries at the Parsons State Insane Asylum before the start of The Secret of Cabot House, Edward Deegan will reprimand you upon speaking to him about the quest. However, this has no effect on the questline.

Companion comments

Location comments
Character Comment
Cait "I don't like admittin' it, but this place is givin' me the shivers."
Codsworth "Are you certain you want to go in there? I doubt time has erased its sordid reputation. It's probably far worse."
Curie "The stories I have read of Parsons are most disturbing."
Danse "All signs point to this location being extremely dangerous. We should proceed with caution."
Deacon "Something about this place. Be careful."
John Hancock "They always said I'd end up in the looney bin."
Nick Valentine "Not sure they're taking new wards, but for us, they might make an exception."
Piper Wright "Parsons. Even the name sounds vaguely macabre."
Preston Garvey "This place has a bad reputation. Just thought you should know."
Robert MacCready "Hey, this place doesn't look so bad. Some paint, a few throw rugs and it'll be good as new."
X6-88 "In the Institute, mental disorders are a thing of the past."


The Parsons State Insane Asylum appears only in Fallout 4.

Behind the scenes



  1. Fallout 4 Vault Dweller's Survival Guide Collector's Edition pp. 276-277: "[2.07] PARSONS STATE INSANE ASYLUM
    Before the Great War, this asylum was built to house the addled, weak of brain, and terminally confused folk of the Commonwealth. Old records state that additional subterranean rooms were created to house particularly difficult guests. The location appears to have been built by the Cabot family of the Beacon Hill neighborhood of Boston. Armed mercenary guards currently patrol the facility."
    (Fallout 4 Vault Dweller's Survival Guide Map)
  2. Parsons State Insane Asylum terminal entries; Jack's office terminal, Patient Records, Patient 001-MS
  3. The Sole Survivor: "Where do you get this serum from?"
    Jack Cabot: "My father, Lorenzo Cabot, is... confined in Parsons. He became dangerously unstable after handling an artifact he found on an archaeological dig in Arabia. He gained various seemingly paranormal powers... as well as becoming increasingly irrational and violent. In the end, I had no choice but to confine him - for his own safety as well as ours."
    (Jack Cabot's dialogue)