Built by the Cabot family and formerly administered by their son Jack, the superintendent, the Parsons State Insane Asylum was home to and cared for Boston area residents deemed mentally ill or insane. Subterranean rooms were constructed in the facility's basement to house the most difficult cases, including Lorenzo Cabot. He was institutionalized for life 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 him with supernatural powers, but also made him mentally unstable, resulting in Lorenzo's admittance to the institution.
In the years following the Great War, the Cabots hired a security team to protect Lorenzo and his secrets from exploitation by outsiders.
A multi-level building. There are a number of locked doors and safes to be found.
- 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.
- 3 overdue books - The first book is inside an open filing cabinet which is on the west side of the very first room you reach after taking the elevator down. The second and third books are both in the control room. Against the east wall of the control room near the door, the player character will find one book inside another filing cabinet drawer, while 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 up a bit.
- Massachusetts Surgical Journal issue #1 - 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.
- 2 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.
- 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 appropriate words CRAZY can be found on a wooden bench in the corridor leading east, when entering the main door.
- Checking Jack Cabot's terminal will show logs of patients that are pop culture references. The first entry is in reference to Alex DeLarge from A Clockwork Orange.
- 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 quest line.
The Parsons State Insane Asylum appears only in Fallout 4.
Behind the scenes
- The Parsons State Insane Asylum is based on the real-life Danvers State Insane Asylum. This can also be considered another H.P. Lovecraft reference, as Danvers State Insane Asylum is mentioned by name in at least 2 of his works. Furthermore, H.P. Lovecraft's Arkham Sanitarium was believed to be inspired by Danvers State, which in turn was the inspiration for Batman's Arkham Asylum. Danvers State has appeared in at least one other video game, it was a level in 2004's Painkiller.
- The patients records found on Jack's office terminal show that the asylum once held a vigilante named "Nightwar," a woman who only wore black leather and a ten year old murderer who was always laughing. This might be a reference to the characters of Batman, Catwoman and the Joker. The latter may also refer to the Pint-Sized Slasher.
- The "Abremalin field" imprisoning Lorenzo appears to be a reference to a historical occult work, The Book of Abramelin.