Having 19 Clinics means that you probably are reading from an extremely old guide . Statues , fountains , radios , televions , paintings , plants . they don ' t do anything , no decorations do . Clinics aren ' t the best for happiness , restaurants are . Doing it with a large settlement just makes it harder . Happiness are effectively a 0100 point scale , each person in a settlement adds to the total scale so 23 settlers means you need 2 , 300 happiness points . Foodwater , sheltered beds and sufficient defense gives 80 each , but that still leaves you needing 480 happiness to get everyone to 100 . And any that are synths can ' t technically nonhuman in the game ' s scripts , and synth settlers are considered nonhuman . Ghouls are considered human . get 100 , they can only get 50 . 19 Clinics is enough to get 100 happiness for 23 people , even if they aren ' t quite getting full happiness from other areas . But having so many people means the likelihood of a synth or simply a bug happening is way higher . The safest and easiest way is to do it with as few settlers as possible . You can do it with one person , one bed , enough defense , food , and water . Not 200 water . There ' s a number of ways to do those needs . You can satisfy enough defense and bonus happiness with two junkyard dogs , from the traps . Each dog is 8 defense and 10 happiness . You can have the one person farm , pop down a turret , and a few of the VaultTec furnitures that provide happiness they specifically indicate happiness , there is an icon for it . You can have the person work a rank 2 or rank 3 bar or clinic , and simply have enough food and water stored in the workshop for them . You can do it with two or three people as well . Make sure the persons you are using are not synths . Kill them , check their corpses for synth components , and reload .