Background: In times of disaster, public servants face multiple burdens as they engage in a demanding and stressful disaster-response work while managing their own needs caused by the disaster. Purpose: We investigated the effects of work-related factors on the mental health of prefectural public servants working in the area devastated by the Great East Japan Earthquake to identify some ideas for organizational work modifications to protect their mental health. Methods: Two months after the earthquake, Miyagi prefecture conducted a self-administered health survey of prefectural public servants and obtained 4,331 (82.8 %) valid responses. We investigated relationships between mental health distress (defined as K6 ≥ 13) and work-related variables (i.e., job type, overwork, and working environment) stratified by level of earthquake damage experienced. Results: The proportion of participants with mental health distress was 3.0 % in the group that experienced less damage and 5.9 % in the group that experienced severe damage. In the group that experienced less damage, working >100 h of overtime per month (adjusted odds ratio [OR], 2.06; 95 % confidence interval [CI], 1.11-3.82) and poor workplace communication (adjusted OR, 10.96; 95 % CI, 6.63-18.09) increased the risk of mental health distress. In the group that experienced severe damage, handling residents' complaints (adjusted OR, 4.79; 95 % CI, 1.55-14.82) and poor workplace communication (adjusted OR, 9.14; 95 % CI, 3.34-24.97) increased the risk, whereas involvement in disaster-related work (adjusted OR, 0.39; 95 % CI, 0.18-0.86) decreased the risk. Conclusions: Workers who have experienced less disaster-related damage might benefit from working fewer overtime hours, and those who have experienced severe damage might benefit from avoiding contact with residents and engaging in disaster-related work. Facilitating workplace communication appeared important for both groups of workers. [ABSTRACT FROM AUTHOR]