The most important thing to take care of first, as said above, is the fatso fighters spawned by it, as they will deal tons of damage if they get the player with their lasers and then crash on them, so the player should take them out as soon as possible. If the player's vehicle is destroyed, they will die, although they will not immediately die if ejected from the vehicle. Albeit having 1,000,000 HP, it takes very heavy damage when shot at the core. The fight itself is pretty straightforward, just rush backwards and shoot any projectile or enemy it spawns, grab the repair power-ups to survive and attack it when its core is exposed, especially if the player has Serious Damage. 
If the player does not finish the boss quickly, it will splatter them with its wheels, killing them instantly.
After that attack, the core stays exposed until the end of the fight. The sixth attack consists of firing a large amounts of missiles. The fifth attack consists of three waves of regular fatso fighters. The fourth attack consists of shooting cannonballs at the player. Unlike the regular counterparts, each one has a larger amount of bombs than the regular fighter, making it nearly impossible to dodge completely. The third attack consists of three waves of modified seagull fighters. 
Its second attack is to launch fireballs at the target. Its first attack are three waves of modified fatso fighters that will crash into the player. 
Going near the Institution's wheels will result in instant death. The Mental Institution has a vast arsenal of weapons: fireball launchers, cannons, rocket launchers, and the ability to spawn a mass force of Fatso Fighters and Seagull Fighters. When Sam defeats all the enemies around the Institution, it will activate its wheels and start moving towards him. The Mental Institution is Mental's home and a pyramidal mobile fortress, and also has a spaceship for an escape emergency (such as Sam's arrival there).
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