Sefton Asylum, an illustration by Fabio Porfidia

Lovecraft Country has plenty of places – some well described like Innsmouth or Dunwich – others more vaguely sketched, like Kingsport or Bolton.  There are a few spots about which we know nearly nothing, like Sefton.  Here is everything HPL ever said about Sefton:

And now Sefton Asylum has had the mishap and West has vanished…

They dressed its wound and carted it to the asylum at Sefton, where it beat its head against the walls of a padded cell for sixteen years—until the recent mishap, when it escaped under circumstances that few like to mention…

He half felt that he was followed—a psychological delusion of shaken nerves, enhanced by the undeniably disturbing fact that at least one of our reanimated specimens was still alive—a frightful carnivorous thing in a padded cell at Sefton…

There was also that Arkham professor’s body which had done cannibal things before it had been captured and thrust unidentified into a madhouse cell at Sefton, where it beat the walls for sixteen years…

He seemed calm even when he thought of that clawed grave and looked over his shoulder; even when he thought of the carnivorous thing that gnawed and pawed at Sefton bars…

Something fearsome and incredible had happened at Sefton Asylum fifty miles away, stunning the neighbourhood and baffling the police…

(All of these quotes come from “Herbert West: Reanimator“.  Chris Jarocha-Ernst lists this as the only story mentioning it in his Cthulhu Mythos Bibliography and Concordance.  Google turns up no other stories, save one or two bits of fan fiction.  It does have a card in the Mythos CCG and a prop Insanity Certificate from the HP Lovecraft Historical Society.)

So, what do we know about Sefton?  It is about 50 miles from Boston’s North End (where Dr. West was hiding out when the Sefton escape occurred).  There is an asylum there that has been open since 1905, when the reanimated body of Dr. Allen Halsey was confined there, and that asylum has grounds and neighbors.  And that’s it…

The Administration building at Grafton

I would humbly like to posit that Lovecraft may have had in mind the Grafton State Hospital in Grafton Massachusetts.  The facility, opening in 1901, was intended for the chronically insane, and was over 40 miles from the site of West’s lab, on a hilly site outside of the farming town of Grafton.  Here’s more information about the facility.

So, if you’re hankering to expand the reaches of Lovecraft Country, Sefton is practically a blank slate, so long as you include an asylum and an insane cannibalistic tenant.